Model Release Form - Template, Sample Form to Complete

Model Release Form

State of Alabama

This Model Release Form relates to the use of personal media and images utilized for an artistic or commercial endeavor by and between the following parties:

________, a photographer, with an address at the following:

________

and

________ ("Model"), with an address at the following:

________

I, ________, for good and valuable consideration, the receipt of which is hereby acknowledged, hereby absolutely and irrevocably authorize ________ as well as their legal representatives, assignees, and transferees to use, publish, reuse, republish, distribute, disseminate or otherwise make publicly available for any artistic or commercial use, including advertising, publication, or illustration images of me and/or my property, of the following description:

________

taken on ________, in whole or in part, whether individually or collectively with any other material, in any and all forms of media now or hereinafter known and/or developed, including, but not limited to, in print media, in digital media, on the Internet, in composite images, or distorted images or for any other lawful use as may be determined by ________ in their sole and exclusive discretion, including the use of my name without restriction. The photographer shall specifically be permitted to use fictitious names in conjunction with the images.

I further completely release and discharge ________ from any and all demands or claims that may arise out of or otherwise be connected with the use of the photographs featuring me, my image or my property, including, without limitation, and any all claims for the violation of a right of publicity, a right of privacy, or libel. I also waive any and all rights to approve or otherwise review any uses of the photographs featuring me, my image or my property.

This authorization and release shall inure to the benefit of the legal representatives, licensees, heirs and assignees of ________ and shall also be binding upon me, my heirs, assignees, and legal representatives.

I specifically acknowledge and agree that the nature of the work may include full or partial nudity. I hereby consent and agree to appear fully or partially nude in the work.

Notwithstanding the above, the following uses are specifically excluded:

________

Lorem ipsum dolor sit amet consectetur adipiscing elit sed do eiusmod tempor incididunt ut labore et dolore magna aliqua ut enim ad minim veniam quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo.

Lorem ipsum dolor sit amet consectetur adipiscing elit sed do eiusmod tempor incididunt ut labore et dolore magna aliqua ut enim ad minim veniam quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat duis aute irure dolor in reprehenderit voluptate velit esse cillum dolore eu fugiat nulla pariatur lorem ipsum dolor sit amet consectetur adipiscing elit sed do eiusmod tempor incididunt ut labore et dolore magna aliqua ut enim ad minim veniam quis nostrud exercitation ullamco laboris.

EXECUTION:

________

Model Signature: ___________________________________

Date: ____________________________________________