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Model Release Form South Texas Heat Magazine I ______________________________ (hereafter "Model"), in the interest of gaining valuable modeling experience and in exchange for photographs of myself, do hereby irrevocably authorize South Texas Heat Magazine (hereafter "Photographer"), and those acting with Photographer's permission, including, but not limited to South Texas Heat Magazine, to use photographs taken by Photographer of myself on from the date of ________________________ and ending on the date of ______________________ and derivative works based thereupon (collectively hereafter the "Photos") for all lawful purposes subject to the terms and conditions described herein. Model agrees that the aforementioned exchange is for photographs delivered to the model by Photographer in the quantity and format described as follows: photographs will be delivered upon request in computer format, such as jpg or bmp. Model further agrees that, while model may use the Photos for purposes related to the promotion of her/his Modeling business, including but not limited to magazines, advertising, portfolios, composite cards, exhibitions, contests, magazines, and internet web sites, Model will not sell publication rights in any or all of the Photos without Photographer's prior consent. Likewise, Model authorizes Photographer to use the Photos for purposes related to the promotion of Photographer's business, including but not limited to magazines, advertising, portfolios, composite cards, exhibitions, contests, and internet web sites, but do not authorize Photographer to sell publication rights in any or all of the Photos except with Model’s prior consent. The Photographer gives the Model "The right to publish" in any media with the following restrictions: The Model must always publish the Photographers’ copyright notice every time and anytime the photos are published. The photos are to be published "as is" that is, without distortion or changing the photos original appearance, with the exception of blemishes and other similar touch-ups. Model hereby releases and agrees to hold harmless Photographer and those acting under his permission, from any liability by virtue of blurring, distortion, alteration, optical illusion, or use in composite form whether intentional or otherwise, that may occur or be produced in the taking of the pictures, or in any processing tending toward the completion of the finished product, unless it can be clearly shown that the foregoing was maliciously caused, and produced, and published solely for the purpose of subjecting Model to conspicuous ridicule, scandal, reproach, scorn, and indignity. Model hereby affirms that all poses, positions and situations enacted in the Photos covered in this release were entered into without force, coercion, or threat whatsoever, and were posed freely by Model with Model's full consent. Model further agrees to hold blameless and free of all accusation of such force or coercion Photographer, his legal representatives, assigns, and those acting under his permission. Model hereby affirms that his/her date of birth is ________________________________ and that Model is fully able to contract in his/her own name without breach of any prior agreement or applicable law, including but not limited to prior agreements with modeling and talent agencies. In addition, paid agreements may be signed for an Official Photo Session. In addition, Model will also receive a compensation of $______ per issue sold during month of publication that includes the model’s photos from Official Photo Session and/or a compensation of $_____ per hour for work done in any other activity, (example: onsite sales promotion, trade show appearance, car show appearance, etc…). Model has read the foregoing prior to its execution and is fully familiar with and agree to the contents thereof.
Model's Signature: _________________________________________ Date: ________________ Name Print: _______________________________________ Date of Birth: ________________ Address: _____________________________________________ Phone: ___________________ Witness Signature: _________________________________________ Date: _______________ Name Print: _______________________________________ Date of Birth: ________________ Photographers Signature: ___________________________________ Date: ________________
