Permission to Photograph
For valuable consideration received, I grant to MARTIN BOHATY and his legal representatives and assigns, the irrevocable and unrestricted right to use and publish photographs of me, or in which I may be included, for editorial, trade, advertising, and any other purpose and in any manner and medium; and to alter and composite the same without restriction and without my inspection or approval. I hereby release Photographer and his/her legal representatives and assigns from all claims and liability relating to said photographs.
MODEL'S SIGNATURE ______________________________________________
WITNESS SIGNATURE ______________________________________________
PRINT NAME ______________________________________________________
WITNESS SIGNATURE ______________________________________________
MODEL’S DATE OF BIRTH ___________________________________________
ADDRESS _________________________________________________________
ADDRESS _________________________________________________________
TODAY’S DATE ____________________________________________________
EMAIL ADDRESS __________________________________________________
TODAY’S DATE ___________________________________________________
LEGAL GUARDIAN SIGNATURE(if under 18) __________________________
PRINT NAME _____________________________________________________
For valuable consideration received, I grant to MARTIN BOHATY and his legal representatives and assigns, the irrevocable and unrestricted right to use and publish photographs of me, or in which I may be included, for editorial, trade, advertising, and any other purpose and in any manner and medium; and to alter and composite the same without restriction and without my inspection or approval. I hereby release Photographer and his/her legal representatives and assigns from all claims and liability relating to said photographs.
MODEL'S SIGNATURE ______________________________________________
WITNESS SIGNATURE ______________________________________________
PRINT NAME ______________________________________________________
WITNESS SIGNATURE ______________________________________________
MODEL’S DATE OF BIRTH ___________________________________________
ADDRESS _________________________________________________________
ADDRESS _________________________________________________________
TODAY’S DATE ____________________________________________________
EMAIL ADDRESS __________________________________________________
TODAY’S DATE ___________________________________________________
LEGAL GUARDIAN SIGNATURE(if under 18) __________________________
PRINT NAME _____________________________________________________