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This Model Release (Revised 1/6/05) is provided as a free service of TravelReporter.com.  If you would like to assist in the cost of maintaining this site and to keep this form online and available in the future, please send one dollar bill (US) to: Travel Reporter, PO Box 891796, Temecula, CA 92589-1796.  Thank you.

Standard Model Release Form
(Click here for printer friendly version)

I,                                                       do hereby give                                                             ,
his/her assigns, licensees, and legal representatives the irrevocable right to use my name (or any fictional name), voice, picture, portrait, photograph or image in all forms and media and in all manners, including composite or distorted representations, for advertising, trade, or any other lawful purpose, and I waive any right to inspect or approve the finished product, including written copy, that may be created in connection therewith, in consideration of $                   , receipt of which is acknowledged.  I am of full legal age.*  I have read this release form        and I am fully familiar with its contents.
 
Witness:

 Signed:
 
Address:

Address:

Date:                   20      
* Delete this sentence if the subject is a minor.  The parent or guardian must then sign the consent below.

Consent (If applicable)

I am the parent and/or legal 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.
 

Witness:
 		 Signed:
 
Address:

Address:


Date:        /        /200        

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