Moon Men DJs, LLCIrondale, AL 35210
(205) 222-1316
For valuable consideration
received, the receipt and sufficiency of which are hereby acknowledged, I
__________________________________________________________________ (name of parent/guardian)
the undersigned parent/guardian of
_________________________________________________, a minor, (name of
talent/model) hereby forever grant to
__________________________________________ (name of photographer or company),
his/her/its legal representatives, successors, assigns, licensees, advertising
agencies, and all persons or
corporations acting with his/her/its permission, the irrevocable and
unrestricted right to use, re-use, publish and re-publish, and copyright
Model/Talent’s performance, likeness, picture, portrait, photograph, sound
and/or voice recording, including the negatives, transparencies, prints, film,
video, tapes, digital or other information pertaining to them in all forms of
media now or hereafter known and in all manner, including electronic media, in
still, single, multiple, moving or video format, in whole or part and/or
composite representations, in conjunction with Model/Talent’s own or a
fictitious name, including alterations, modifications, derivations and
composites thereof, throughout the world and universe for advertising,
promotion, trade, or any lawful purposes.
This right shall include the
right to use the Talent/Model’s name or to combine the Talent/Model’s likeness
with others and to alter Talent/Model’s likeness, by digital means or
otherwise, for the purposes set forth herein.
I waive any right to inspect
or approve the finished product, including written copy that may be created in
connection therewith or the use to which it may be applied.
I acknowledge that the
photography session and/or film or video production was conducted in a
completely proper and highly professional manner, and this release was
willingly signed at its termination. I acknowledge that the Model is a minor,
and certify that we have given our consents freely
I, hereby warrant that I am
the parent or guardian of the minor named above, that I have read and
understood this Release and have the legal authority to execute the above
release without breach of any prior agreement or applicable law, including but
not limited to prior agreements with modeling or talent agencies or any other
person, company or entity. I hereby release and agree to indemnify the licensed
parties and their respective successors and assigns, from and against any and all
liability arising out of the exercise of the rights granted by the above
Talent/Model Release. I approve the foregoing and waive any rights in the
photographs. This agreement shall be binding upon me and my heirs, legal
representatives and assigns.
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_________________________________ (Date) |
_______________________________________________ (Minor’s Name) _______________________________________________ (Signature of Parent or
Guardian) _______________________________________________ (Name Parent or Guardian) _______________________________________________ (Address) _______________________________________________ _______________________________________________
(Phone) |