Model Release printable pdf download

Model Release

I, ____________________________________________________________________ , grant

to the University of Maryland, Baltimore County all rights necessary to enable UMBC to use my

name, image or photograph in all forms and in any media and in any publication or published

[capacity] format, and to otherwise use and publish it without remuneration to me and without

incurring any debt [of] or liabilities to me of any kind. I intend and direct that this release be bind-

ing on my heirs, beneficiaries or assigns.

Name ____________________________________________Date ______________________

Address ______________________________________________________________________

Phone________________________________________________________________________

Email ________________________________________________________________________

Signature ____________________________________________________________________

Witness ______________________________________________________________________

Consent

I am the parent or guardian of the minor named above and have the legal authority to execute

the above release. I approve the foregoing and waive any rights in the premises.

Parent/Guardian ________________________Signature ______________________________

Address ______________________________Phone ________________________________

Date __________________________________Witness ________________________________

University of Maryland, Baltimore County

1000 Hilltop Circle

Baltimore, MD 21250

6/01

Model Release