Model Release - Istock
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1Model Release
Attach Visual Reference of Model here:
(Aligned to top right-hand corner if larger than box.)
For Consideration herein acknowledged as received, and
by signing this release I hereby give the Photographer /
For example, Polaroid, drivers license, print, photocopy,
Filmmaker and Assigns my permission to license the
etc.
Content and to use the Content in any Media for any
purpose (except pornographic or defamatory) which
may include, among others, advertising, promotion,
marketing and packaging for any product or service. I
agree that the Content may be combined with other
images, text, graphics, film, audio, audio-visual works; and
may be cropped, altered or modified. I acknowledge
and agree that I have consented to publication of my
ethnicity(ies) and gender as indicated below, but
understand that other ethnicities or gender may be
associated with me by the Photographer / Filmmaker
and / or Assigns for descriptive purposes.
I agree that I have no rights to the Content, and all rights
Model Information
to the Content belong to the Photographer / Filmmaker
and Assigns. I acknowledge and agree that I have no
Name (print)
further right to additional consideration or accounting,
Date of Birth
(DD/MM/YEAR)
and that I will make no further claim for any reason to
Photographer / Filmmaker and / or Assigns. I
Gender male [ ]
female [ ]
other [ ] ______________
acknowledge and agree that this release is binding upon
Model (or Parent*) Information
my heirs and assigns. I agree that this release is
irrevocable, worldwide and perpetual, and will be
Residence Address
governed by the laws (excluding the law of conflicts) of
the country/state from the following list that is nearest to
the address of the Model (or Parent*) given opposite:
City
State/Province
New York, Alberta, England, Australia and New Zealand.
Country
Zip/Postal Code
It is agreed that my personal information will not be made
Phone
Email
publicly available but may only be used directly in
relation to the licensing of the Content where necessary
Signature
(e.g. to defend claims, protect rights or notify trade
Date Signed
(DD/MM/YEAR)
unions) and may be retained as long as necessary to fulfill
this purpose, including by being shared with sub-licensees
*If Model is a minor or lacks capacity in the jurisdiction of
/ assignees of the Photographer / Filmmaker and
residence, Parent warrants and represents that Parent is the
transferred to countries with differing data protection and
legal guardian of Model, and has the full legal capacity to
privacy laws where it may be stored, accessed and used.
consent to the Shoot and to execute this release OF ALL
I represent and warrant that I am at least 18 years of age
RIGHTS IN MODEL’S CONTENT. If you are signing in this
and have the full legal capacity to execute this release.
capacity, please enter your details above and your name
Definitions: “ASSIGNS” means a person or any company to
below.
whom Photographer/Filmmaker has assigned or licensed
Parent Name:
rights under this release as well as the licensees of any
if applicable
such person or company. “CONSIDERATION” means $1 or
Additional information to be completed by Model:
something else of value I have received in exchange for
(Optional)
the rights granted by me in this release. “CONTENT” means
all photographs, film, audio, or other recording, still or
Ethnicity information is requested for descriptive purposes
moving, taken of me as part of the Shoot. “MEDIA” means
only, and serves as a means of providing more accuracy
all media including digital, electronic, print, television, film,
in assigning search words.
radio and other media now known or to be invented.
___Asian – circle all that applies to you:
“MODEL” means me and includes my appearance,
(Chinese, Indian, Japanese, Korean, other)
likeness and voice. “PARENT” means the parent and/or
legal guardian of the Model. Parent and Model are
___ Caucasian, White ___Hispanic, Latin
referred to together as “I” and “me” in this release, as the
___Middle Eastern ___Native American ___Pacific Islander
context dictates. “PHOTOGRAPHER / FILMMAKER” means
photographer, illustrator, filmmaker or cinematographer,
___Black
___Mixed Race
___African American
or any other person or entity photographing or recording
Other: __________________________
me. “SHOOT” means the photographic, film or recording
session described in this form.
Witness to Model’s signature (NOTE: All persons signing and
Photographer/Filmmaker Information
witnessing must be of legal age and capacity in the area in
Name (print)
which this Release is signed. A person cannot witness their own
Signature
release)
Date Signed
(DD/MM/YEAR)
Name (print)
Shoot Date
Signature
Shoot Country & Region/State
Date Signed
(DD/MM/YEAR)
Shoot Description/Ref. (if applicable)
Model Release – English – May 2015
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