Sample Model Release
Sample Model Release
Little Eva Presents
Screen Name: (model’s screen name)
Program: Little Eva’s Tryouts
In consideration of One Thousand Dollars ($1,000.00), the receipt of which is hereby acknowledged, I give Little Eva Presents the absolute right and permission to use, copyright and publish images, portraits, pictures, films or video tapes of me, or in which I may be included in whole or in part, in conjunction with my own or a ictitious name; or reproductions thereof in color or otherwise, made through any media at their studios or elsewhere, for art, advertising, trade, or any other lawful purpose whatsoever.
I hereby waive any right I may have to inspect or approve the inished product or the advertising copy, printed, or internet-published matter that may be used in conjunction therewith, or the use to which it may be applied.
My participation in the program confers upon me no rights of use, ownership or copyright. I release Little Eva Presents, its employees, agents, and assigns from all liability which may arise from any and all claims by me or by any third party in connection with my participation in the program.
I understand that Little Eva Presents is under no obligation to distribute or broadcast the above-identiied program or series; or to include my performance.
This document constitutes the entire agreement between Little Eva Presents and myself.
I hereby represent and certify that I am of legal age and competence, and have read this authorization and release prior to its execution. I have not been induced, other than by the consideration and compensation received, to execute this agreement by any representations or statements made by Little Eva Presents, or its agents, employees, or anyone acting on its behalf.
Signature: (model’s signed name) Date: (date)
Name: (model’s printed name)
Address: (model’s street address)
City: (model’s city) St: (state) Zip: (zipcode)
Date of Birth: (model’s date of birth)
SSN: (model’s social security no.)
ID Kind: (kind of ID) Number: (ID’s number)
* Phone: (model’s phone number)
* E-mail: (model’s e-mail)
* optional information
(note: we also have a text-only version of this file that you can print out.)
