Skip to content
adultreleaseform
admin
2020-08-26T02:10:53+00:00
ADULT MODEL RELEASE FORM
Please fill out the form and send it before the photo session.
Please enable JavaScript in your browser to complete this form.
I, (name listed below) granting permission to Julisa S. Marquez (or the professional photographer designed by her) to make photographs of me.
*
First
Middle
Last
FOR VALUABLE CONSIDERATION: I hereby confer to Julisa S. Marquez on today's date (date listed at the end of this document), the absolute and irrevocable right and permission with respect to the photographs that she has taken of me in which she may be included with others: A) To copyright the same in Julisa S. Marquez‘s name or any other name that she may select; B) To use, re-use, publish and re-publish the same in whole or in part, separately or in conjunction with other photographs, in any medium now or hereafter known, and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion, advertising and trade, and; To use my name in connection therewith if she so decides. C) I hereby release and discharge Julisa S. Marquez from all and any claims and demands ensuing from or in connection with the use of the photographs, including any and all claims for libel and invasion of privacy. This authorization and release shall inure to the benefit of the legal representatives, licensees and assigns of photographer Julisa S. Marquez as well as the person(s) for whom she took the photographs. I have read the foregoing and fully understand the contents hereof. For agreement, trade deal, and/or value received, I hereby consent to the foregoing on her behalf.
*
Yes
No
Model's email address
*
Model's phone number
*
NOTICE: PLEASE ONLY NUMBERS. DO NOT INCLUDE DASHES OR ANY SORT OF SYMBOL.
DISCLAIMER: I warrant that I am of full age and have every right to contract for myself in this regard. I state further that I have read the above authorization, release, and agreement, prior to its execution, and that I am fully familiar with its contents.
*
Yes
No
Electronic Signature and date
*
First
Last
Message
Submit