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Self Model Release Example

This document is a self-release form for models granting permission to photographers to use their likeness in various media. It includes sections for personal information, details about the shoot, and signatures from the model and photographer. The release allows for commercial use of the images without restrictions and is binding on the model's heirs and assigns.

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Shoffaina qothrun nada
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6 views1 page

Self Model Release Example

This document is a self-release form for models granting permission to photographers to use their likeness in various media. It includes sections for personal information, details about the shoot, and signatures from the model and photographer. The release allows for commercial use of the images without restrictions and is binding on the model's heirs and assigns.

Uploaded by

Shoffaina qothrun nada
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

MODEL RELEASE FORM (SELF-RELEASE)

Photographer / Model Information


Full Name: _______________________________

Date of Birth: ____________________________

Address: _________________________________

Email: __________________________________

Phone: __________________________________

Description of Shoot

I, the undersigned, grant permission to use my likeness, image, and appearance as captured in
photographs, video, or other media taken on (Date): __________ at (Location): __________.

I agree that the images may be used for commercial purposes including advertising, promotion,
and distribution worldwide, in any medium, without restriction.

This release is binding upon me, my heirs, and assigns.

Signatures

Model/Photographer Signature: _______________________ Date: __________

Witness (optional): ________________________________ Date: __________

This is a sample self model release form. Adapt as required for submission.

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