MODEL RELEASE FORM Friends of Northampton Trails and Greenways Photo and Video Contest 2012 PO Box 60643 Florence, MA 01062-‐0643 http://www.fntg.net
I hereby give permission to [________________________________________ (photographer’s or videographer’s name here) _____] to use my name and photographic likeness in all forms and media for advertising, trade, and any other lawful purposes. Print Name: Signature: Date: If model is under 18: I, , am the parent/legal guardian of the individual named above, I have read this release and approve of its terms. Print Name: Signature: Date: