JOHN PARISI NW CONNECTICUT 860.601.8596 eyephotollc@email.com
Model Release In exchange for _________________________________, I hereby give John Parisi permission to use my name and photographs taken on this day (and in any subsequent photo shoots) in all forms and media for any lawful purpose, without further compensation to me. I understand that I will also be able to use and display these images, unaltered and with proper credit given, in my own promotions. Model’s Name (print) ________________________________________________ Signature:
_________________________________ Today’s Date: _________
Date of Birth: __________________ Address:
________________________________________________________ ________________________________________________________
Phone:
________________________________________________________
Email:
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(If the person signing is under 18, consent must be given by the parent or guardian.) I hereby certify that I am the parent or guardian of _______________________________________, the model named above, and for the value received, I do give my consent without reservations to the foregoing on behalf of him or her or them. Name (print) _____________________________________________________ (name of parent or guardian) Signature:
______________________________________________________ (signature of parent or guardian)