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Photo Release

SAMPLE PHOTO RELEASE FORM
 
I, the undersigned, do hereby consent and agree that , has the right to take photographs, videotape, or digital recordings of me and/or the undersigned minor children beginning on and ending on and to use these in any and all media, now or hereafter known, and exclusively for the purpose of . I further consent that my name and identity may be revealed therein or by descriptive text or commentary.
 
I do hereby release to , all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.
 
I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.
 
I also understand that is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result.
 
I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.
 
Name:  __________________________________________________________        Date:    _____________________________________________________________________________
 
Address: __________________________________________________________________________________________________________________________________________________      
                  
Phone:   ___________________________________________________________________________________________________________________________________________________         
 
Signature: _________________________________________________________________________________________________________________________________________________
 
Names and Ages of Minor Children:
 
Name: _________________________________________________________________________________  Age:  _____________________________________________________________
 
Name: _________________________________________________________________________________  Age:  _____________________________________________________________
 
Name: _________________________________________________________________________________  Age:  _____________________________________________________________ 
          
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