Model Release Form

This form along with the property release form above is based off of the forms found Here. These forms are free to use and offer many different types of forms in different languages. The reason I favored using these as a template were that they were very descriptive and and contained a lot of information that is there to protect both parties. The interesting thing with this form is that it does tie a minor release into the the adult release form. I took out very little in these, mainly to avoid clutter here on the site and to simplify it somewhat, but if I was to have someone sign this, I would most likely use the whole form.

Adult Model Release with Minor option

For Consideration herein acknowledged as received, and by signing

this release I hereby give Ben Sherman and Assigns

my permission to license the 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)

as indicated below, but understand that other ethnicities may be

associated with and / or Assigned for descriptive purposes by

Ben Sherman.

I agree that I have no rights to the Content, and all rights to the

Content belong to Ben Sherman and Assigns. I

acknowledge and agree that I have no further right to additional

consideration or accounting, and that I will make no further claim

for any reason to Ben Sherman and / or Assigns. I

acknowledge and agree that this release is binding upon my heirs

and assigns. I agree that this release is irrevocable, worldwide and

perpetual, and will be 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: New York,

Alberta, England, Australia and New Zealand.

It is agreed that my personal information will not be made publicly

available but may only be used directly in relation to the licensing of

the Content where necessary (e.g. to defend claims, protect rights

or notify trade unions) and may be retained as long as necessary

to fulfill this purpose, including by being shared with sub-licensees

/ assignees of Ben Sherman and transferred to

countries with differing data protection and privacy laws where it may

be stored, accessed and used. I represent and warrant that I am at

least 18 years of age and have the full legal capacity to execute this

release.

Photographer/Filmmaker Information

Name (print) _________________________________________________

Signature ___________________________________________________

Date signed (DD/MM/YEAR) _______________________________________

Shoot Date __________________________________________________

Shoot Country & Region/State __________________________________

Shoot Description/Ref. (if applicable) ________________________________

Model Information

Name (print) _____________________________________________________

Date of Birth (DD/MM/YEAR) ___________________________________________

Gender: male female

Model (or Parent*) Information

Residence Address _______________________________________________

City __________________________________ State/Province _____________

Country _____________________________ Zip/Postal Code _____________

Phone _______________________ Email _____________________________

Signature _______________________________________________________

Date signed (DD/MM/YEAR) ___________________________________________

*If Model is a minor or lacks capacity in the jurisdiction of residence, Parent

warrants and represents that Parent is the legal guardian of Model, and has

the full legal capacity to consent to the Shoot and to execute this release OF

ALL RIGHTS IN MODEL’S CONTENT. If you are signing in this capacity, please

enter your details above and your name below.

Parent Name:___________________________________________________

if applicable.

Witness (NOTE: All persons signing and witnessing must be of legal age and

capacity in the area in which this Release is signed. A person cannot witness their

own release)

Name (print) _____________________________________________________

Signature _______________________________________________________

Date signed (DD/MM/YEAR) ___________________________________________

Adult & Minor Release - January 2010