Model Release



For valuable consideration as listed below, I, ____________________________________________, hereby give the photographer: Victor H. Schlosser / Photo by Vic, his legal representatives and assigns my permission to Copyright and license the Images and to use the Images in any Media for any purpose (except pornographic or defamatory) which may include, among others, advertising, promotion and marketing. I agree that the Images may be combined with other images, text and graphics, and cropped, altered or modified.

I agree that I have no rights to the Images, and all rights to the Images belong to the Photographer and Assigns. I acknowledge and agree that I have no further right to additional Consideration or accounting, and that I will make no further claim for any reason to Photographer or Assigns. I acknowledge and agree that this release is binding upon my heirs and assigns. I agree that this release is irrevocable, worldwide and perpetual.

I hereby waive any right to approve the finished Images or any copy which might be used in conjunction with the finished Images.

Compensation is to be as follows:








I have read the foregoing release, authorizations and agreement, before Affixing my signature below and represent and warrant that I am at least 18 years of age and have the full legal capacity to execute this release.


DATE:___________________                              STAGE / MODELING NAME:________________________________________


LEGAL NAME:________________________________________ SIGNATURE:________________________________________

ADDRESS:___________________________________________________________________

ADDRESS:___________________________________________________________________

E-MAIL:_____________________________________________________________________

URL:________________________________________________________________________


WITNESS:___________________________________________DATE:___________________