Minor Model Release

Job Number: Contract Reference Number.

MINOR MODEL RELEASE

For valuable consideration received, I ("undersigned") hereby grant to Company Name ("Photographer") the absolute and irrevocable right and unrestricted permission to use, re-use, display, distribute, transmit, publish, re-publish, copy, or otherwise exploit, either in whole or in part, stills or motion picture, either digitally, in print, or in any other medium now or hereafter known, for any purpose whatsoever and without restriction, photographs taken of me, my likeness or in which I may be included ("Materials"); to alter the same without restriction; and to copyright the same. I understand and agree that Photographer may or may not use my name in conjunction with the photographs as he or she so chooses. I understand that all of my actions, activities and speech may be recorded at any time and that the devices used for recording may not be apparent or obvious to me. I understand that Photographer may include or alter Materials contained in any finished product that contains my image or likeness.

Changes may include, but are not limited to: fictional or actual incidents, characters, names, stories, scenes, events, inventions, advertising, dialogue, edits and changes to photos, alterations, airbrushing, blurring, distortion, photo enhancement, overdubs or changes and any other additions to any Materials bearing my image or likeness. I understand that I waive all rights to inspect, approve, object or otherwise be consulted in any form concerning any Materials or advertising produced bearing my likeness. I hereby release and discharge Photographer, and his or her agents, representatives, and assignees from any and all claims and demands arising out of or in connection with the use of the photographs, including without limitation any and all claims for intentional or unintentional acts or omissions, invasion of privacy, right of publicity, and defamation; all claims of liability resulting from any personal property, residual payments, license fees, taxes, reuse of published Materials or any other use of my likeness or image; all liability resulting from lost wages, loss of employment; and all liability for compensation for the Materials or their rights granted hereunder.

Entire Agreement

This Agreement contains the entire agreement between the parties relating to the subject matter hereof and supersedes any and all prior agreements or understandings, written or oral, between the parties related to the subject matter hereof. No modification of this Agreement shall be valid unless made in writing and signed by both of the parties hereto.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of State. Exclusive jurisdiction and venue shall be in the County County, State Superior Court.

Binding Effect

This Agreement shall be binding upon and inure to the benefit of Photographer and his or her respective successors and assigns, provided that Photographer may not assign any of his or her obligations under this Agreement without the undersigned's prior written consent. This release shall be binding upon me, my heirs, legal representatives, and assigns. I represent that I am over the age of eighteen (18) years and that I have read the foregoing and fully understand its contents. This release shall be binding upon me, my heirs, legal representatives, and assigns.

I acknowledge that should any dispute arise out of this release, my appearance in any of the Materials in part or in whole, or any advertising of such Materials, I will submit such dispute in writing to Company Name. Company Name shall then have the absolute right and option to have the matter resolved by Binding Arbitration in the County County of State and acting under the rules of and appointed by the American Arbitration Association. Failure to enter into binding arbitration by either party at this point may require legal action in a court of competent jurisdiction.

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Social Security Number:

Date when the contact was signed.

IF I AM UNDER THE AGE OF 18 YEARS, MY PARENT OR LEGAL GUARDIAN MUST SIGN BELOW:

IMPORTANT: If possible, have both of the minor's parents sign the agreement to prevent potential problems if one of the parents is not aware of the release which could result in one parent trying to negate the agreement. I, the parent or guardian of the minor who signed the above release, do herby consent to the signing of such an agreement and release, and do hereby agree to hold harmless and defend beneficiaries of the release against any claim(s) that the minor may make (before or after reaching the age of majority) due to any use of the Materials, as described in the above Model Release, in any manner permitted by such release. I fully understand that any beneficiaries of the release are and will be relying upon my agreement and signature which are intended to induce them to accept the release.

Signature of 1st Parent or Legal Guardian:

Date when the contact was signed.

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Phone Number:

Signature of 2nd Parent or Legal Guardian:

Date when the contact was signed.

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Phone Number: