Transcript
MODEL RELEASE FORM I, ____________________________, hereby authorize Lollipop Magazine to use my photograph(s) in any manner it so chooses. This includes being printed in the magazine, on the website, or in any advertisement or promotional material it wishes. I agree that there are to be no fees, commissions or royalties paid to me for the use of the photograph(s). I am over 18 years of age. ________________________________ ______________ Model’s Signature Date (_____) _____-_______ Phone
(_____) _____-_______ Fax
_______________________________ email _________________________________________________ Mailing Address line 1 (confidential) _________________________________________________ Mailing Address line 2 (confidential) Information as it will be printed: _____________________ ___________________________ Model name/nickname Photo credit (name, company, email and url) Do you want yer email listed?
___ yes
___ no
Do you want to be a spokemodel for events in your area? ___ yes ___ no Any website(s) you’re on. Myspace, OMP, Modelmayhem, or any of the fine altporn sites. We’re totally cool with linking to them. There’s only room for ONE link beneath yer photo, with more on the general Models index page. Please specify the main link you want beneath your photos. MAIN LINK__________________________________________________ Additional link__________________________________________________ Additional link__________________________________________________ Additional link__________________________________________________ Lollipop Magazine PO Box 441493 Boston, MA 02144 617-890-1880 (fax)
FASHION CREDITS (only required for fashion shoots, not tee shirt shoots) Model info Name/nickname: ________________________________ Link(s): ________________________________________ Photographer info Name: _________________________________________ Link(s): ________________________________________ Hair and Makeup info (optional) Name: _________________________________________ Link(s): _________________________________________ ITEMS MODELED (if ya wear more than one outfit, ya need to fill out one sheet per outfit) Headware Official item name: _______________________ Price: __________________________________ Link(s): ________________________________
Accessories (continued) Official item name: _______________________ Price: __________________________________ Link(s): ________________________________
Top Official item name: _______________________ Price: __________________________________ Link(s): ________________________________
Official item name: _______________________ Price: __________________________________ Link(s): ________________________________
Bottom Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Footware Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Accessories Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Official item name: _______________________ Price: __________________________________ Link(s): ________________________________
Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Additional items (location, whose bike yer on, shot glasses, posters in the background, that kinda thing. Credits get us more free stuff!) Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Official item name: _______________________ Price: __________________________________ Link(s): ________________________________ Official item name: _______________________ Price: __________________________________ Link(s): ________________________________
Lollipop Magazine PO Box 441493 Boston, MA 02144 617-890-1880 (fax)
