Sample Model Release
Date:__________
Photographer: Mark M. Hancock
123 Main Street #1234
Plano, TX 75093
Home (555) 555-5555
Cell (555) 555-5555
DESCRIPTION OF PHOTOGRAPHS:
______________________________
For consideration received, I give Mark M. Hancock permission to reproduce the photograph(s), audio and/or video recording(s) described, and I agree that Mark M. Hancock, and all licensees and assignees, are entitled to use the photograph(s), audio and/or video recording(s) described above in any manner or form whatsoever, either wholly or in part, in any medium, and in conjunction with any wording or other photographs or drawings, worldwide. I understand that I do not own the copyright of the photograph(s), audio and/or video recording(s). I understand that all negatives, positives and digital images together with the prints and/or recordings shall constitute your property, solely and completely.
NAME OF MINOR (printed): ____________________________________
- I am over the age of majority. _____ (initial)
SIGNER'S NAME (printed): ___________________________________
SIGNATURE: ___________________________________
ADDRESS: _____________________________________
PHONE: _______________________________________
WITNESS: _____________________________________
Thank you for your cooperation!
Please read Get model releases for detailed information about model releases.
 
Labels: sample form
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