MODEL RELEASE

To: (Photographer) [insert photographer name] .. .. [insert photographer address]

I . [insert model name] of .. [insert model address] acknowledge and agree that: 1. 2. in this release Photographer includes the Photographers licensees, assignees and associates; the Photographer has the unrestricted right to photograph or film me to the extent permitted by law, using any technology or media including but not limited to digital, electronic, print, television and film media now known or to be invented (Media); the Photographer may produce an image, photograph or film (Image) of me using the Media, throughout the world; my Image may be edited, stored, copies made of and reused at the sole discretion of the Photographer; my Image may portray my age, sex, ethnicity and other physical attributes (Attributes) in its original form or edited form; the Attributes may be blurred or distorted or altered in any manner and I waive any right to inspect or approve the intermediary product or the finished product; I release the Photographer from any claim by me or anyone else arising out of use of my Image; my Image may be published or distributed by the Photographer, using the Media throughout the world on any website or in any publication, video or film, for commercial or non commercial purposes, without restriction (to the extent permitted by law), as an intermediary product or a finished product. For the avoidance of doubt the Photographer may make the Image available for resale to third parties for the reproduction and/or distribution by that third party in any medium throughout the world; the Photographer is not obliged to include my Image in any website, publication, video or film or for any other commercial or non commercial purpose; other than the publicity I may receive if the Photographer use my Image, no further consideration is due to me for this release; this release is irrevocable, worldwide and perpetual, and will be governed by the law of New South Wales, Australia; I have read the above release and fully understand the contents and consequences of such release and that it shall be binding upon me, my heirs, my legal representatives and my assigns and I willingly sign this release; and I am over the age of eighteen (18) years and hereby warrant that I sign this release without breach of any prior agreements or applicable law including but not limited to prior agreements with modelling or talent agencies or any other person, company or entity.

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13.

Signature

Signature of Witness

Date

Name of Witness

Date