Model Release Form - Template, Sample Form to Fill out

MODEL RELEASE FORM

This Model Release Form (the "Release") is made on ________ between ________, an individual of the following address:

________

AND

________, an individual, of the following address:

________

1. THE WORK

The Parties agree that the Publisher shall publish the photograph (the "Work") featuring the Model that the Publisher desires to publish. The Work to which this Release relates includes the following:

________

The Model consents to the use of the Model's image to produce and publish the Work.

2. USE OF WORK

The Publisher, their licensees, assignees, successors, and other authorized agents shall use the Work in the following manner (the "Purpose"):

________

The Publisher may not use the Work for any other purpose other than the Purpose described above.

3. CONSENT AND RELEASE

By signing this Release:

(I) the Model agrees that the entire copyright in relation to the Work belongs to the Publisher, and the Publisher shall have the exclusive perpetual right to use and publish the photograph of the Model and other derivative works for commercial gain, advertisement, or for such other purpose as the Publisher may determine.

(II) the Publisher or their authorized representatives, assignee, licensees, or other authorized persons may alter photograph of the Model and use it for whatever purpose.

(III) the Model acknowledges that the Publisher retains the absolute and exclusive right, interest, and title to the Work and any reproduction of the Work.

(IV) The Model consents to the use of the Model's name together with the Work.

(V) The Model consents to the use of other fictitious name together with the Work.

4. CONFIDENTIALITY OBLIGATIONS

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(I) which can be established by written records to be already known to the Receiving Party or the public at the time of the disclosure;

(II) which enters the public domain through no fault of the Receiving Party;

(III) is given by the Disclosing Party to third parties without any restrictions;

(IV) is given to the Receiving Party by any third party who is in possession of such information and has the legal right to disclose it; or

(V) that is required by law to be disclosed.

Trade secret information includes all formulas, pattern, designs, process, methods or other information that is not known or easily ascertainable to the general public.

The Parties hereby agree as follows:

(I) to take proper and reasonable measures to ensure the confidentiality of the confidential information under this Release;

(II) to use the confidential information solely for the purpose for which it was disclosed and not for any other purpose whatsoever;

(III) not to disclose, reproduce, or otherwise make available the confidential information to any third party without the prior written consent of the Disclosing Party;

(IV) to return or destroy all confidential information, including any copies thereof, upon the request of the Disclosing Party or upon the termination of this Release. This obligation of confidentiality shall survive the termination of this Release.

5. GOVERNING LAW

This Release shall be governed by and construed in accordance with the laws of the Federal Republic of Nigeria, and the Parties hereby submit to the exclusive jurisdiction of the Nigerian courts in respect of any dispute arising out of or in connection with this Release.

IN WITNESS whereof, the Parties have signed this Release in the day and year first mentioned above.

SIGNED SEALED AND DELIVERED by the Publisher

_______________________
________

in the presence of:

Name..................................................................................................................

Address..............................................................................................................

Occupation.........................................................................................................

Signature............................................................................................................

SIGNED SEALED AND DELIVERED by the Model

____________________
________

in the presence of:

Name..................................................................................................................

Address..............................................................................................................

Occupation.........................................................................................................

Signature............................................................................................................