Model Release
EXTERNAL
DEFINITIONS
“PHOTOGRAPHER / VIDEOGRAPHER” means photographer, Photographer / Videographer Info
illustrator, filmmaker, cinematographer, or any other person or
entity photographing or recording me. Full Name: _________________________________
“CONTENT” means all photographs, video, audio, or other Shoot Date: ________________________________
recording, taken of me as part of the Shoot.
Shoot State/Province: ________________________
“MEDIA” means all media including digital, electronic, print, Shoot Country: ______________________________
television, film, radio and other media now known or to be
invented. Photographer / Videographer Signature:
“MODEL” means me and includes my appearance, likeness, and
voice. __________________________________________
“PARENT” means the parent and/or legal guardian of the Model. Model Information
Parent and Model are referred to together as “I” and “me” in this
release, as the context dictates. Full Name: _________________________________
“SHOOT” means the photographic, video or recording session Date of Birth: _______________________________
described in this form.
Gender: Male Female
CONSENT I identify as _____________________
My signature on this release hereby gives the Photographer /
Videographer my permission to license the Content and to use the Parent / Guardian Full Name (if under 18yrs)
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, Street Address:
graphics, video, audio, audio-visual works; and may be cropped,
altered or modified. I agree and acknowledge that I have __________________________________________
consented to publication of my race, ethnicity(ies) and gender as
City: _________________ Province / State: _______
indicated below, but understand that other descriptions of my
ethnicities or gender may be associated with me by Photographer Country: ___________________________________
/ Videographer.
Phone: ____________________________________
I agree that I have no rights to the Content, and all rights to the
Content belong to Photographer / Videographer. I acknowledge Email: _____________________________________
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 Model Race & Ethnicity
Photographer/Videographer. I acknowledge and agree that this Select all that apply. Be as specific as possible.
release is binding upon my heirs and assigns. I agree that this Black Asian Hispanic/Latinx
release is irrevocable, worldwide and perpetual, and will be
governed by the laws (excluding the law of conflicts) of the Indigenous/Native Middle Eastern Other
country/state from the following list that is nearest to the address
of the Model (or Parent*) given opposite: New York, Alberta, Mother’s Ethnicity: ___________________________
England, Australia and New Zealand.
Father’s Ethnicity: ___________________________
I represent and warrant that I am at least 18 years of age and
have the full legal capacity to execute this release. Model Signature or Parent / Guardian (if under 18yrs)
__________________________________________
POCSTOCK, Inc. Last Updated 01/24/2020 Date Signed: _______________________________
