Please complete this form, print it out, BEFORE PRESSING SUBMIT
and sign and mail it to the address below.
Thank you.
FOR VALUABLE CONSIDERATION, receipt of which is hereby
acknowledged, I hereby grant the photographer ("Gil T Friedman") the
irrevocable right and permission, throughout the world, in connection with the
photographs he has taken of me, or in which I may be included with others, the
following: (a) the right to use and reuse, in any manner at all, said
photographs, in whole or in part, modified or altered, either by themselves or
in conjunction with other photographs, in any medium or form of distribution,
and for any purposes whatsoever, including, without limitation, all promotional
and advertising uses, and other trade purposes, as well as using my name in
connection therewith, if he so desires; and (b) the right to copyright said
photographs in his own name or in any other name that he may select. I waive the
right to inspect or approve any use thereof.
I hereby forever release and discharge Photographer from any and all claims,
actions and demands arising out of or in connection with the use of said
photographs, including, without limitation, any and all claims for invasion of
privacy and libel. This release shall inure to the benefit of the assigns,
licensees and legal representatives of Photographer, as well as the party(ies)
for whom he took said photographs.
Please check one:
______ I represent that I am over the age of eighteen years and that I have read
the foregoing and fully and completely understand the contents hereof.
______ I represent that the model is a minor and that I am the parent or duly
authorized representative of the model and that I have read the foregoing and
fully and completely understand the contents hereof.
Mail the completed and signed form to: