Portrait Model Release Form

Name *
Name
Address *
Address
Phone *
Phone
I, for good and valuable consideration, the receipt of which is acknowledged, give to Elizabeth Cryan (Photographer), her legal representatives, successors, and all persons or corporations acting with her permission, unrestricted permission to copyright and/or use, and/or publish photographic portraits or pictures of me and my family, and the negatives, transparencies, prints, or digital information pertaining to them, in any and all media, or in which I may be included in whole or in part, or composite, or distorted in form, or reproductions thereof, in color or otherwise, made through any media in her studio or elsewhere for art, or any other lawful purpose. I hereby waive any right that I may have to inspect and approve the finished product or copy that may be used in connection with an image that Elizabeth Cryan has taken of me or my family, or the use to which it may be applied. I hereby release, discharge, and agree to hold harmless Elizabeth Cryan, her heirs, legal representative assigns, and all persons acting under her authority or those for whom he/she is acting, from any liability by virtue of any use of the photographs or any changes or alterations made thereto. I herby warrant that I am of full legal age and have the right to contract in my own name. I have read the above authorization, release, and agreement, prior to its execution, and I am fully familiar with the contents thereof. This release shall be binding upon me and my heirs, legal representatives, and assigns. By signing below, I agree to the above.
I agree... *
Date *
Date