Child Image Release Form

 

Parent or Guardian “Model” Release for Child

I am the parent or guardian of the child named below and I have the legal authority to execute this release on behalf of the child.

In consideration of the child’s engagement as a model, I give Priceless Memories Photography (“Photographer”) and its employees, heirs or agents the irrevocable, perpetual, and unrestricted right to take and use photographs of the child named below taken by the Photographer (the “Photographs”) in all forms, media and manners, in conjunction with the child’s or a fictitious name, for advertising, trade, promotion, exhibition, or any other lawful purposes.

I waive any right to review or approve the Photographs, the use of the Photographs, or the matter that may be used in conjunction with the Photographs now and in the future, regardless of whether that use or matter is known to me.

I waive any right to royalties or other compensation arising from or related to the use of the Photographs. I release, discharge, and agree to hold harmless the Photographer and its employees, heirs or agents and assign from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking, processing, or publication of the Photographs.

This release shall be binding upon me, my heirs, agents and legal representatives.

I also understand that Priceless Memories Photography is not responsible for any expense or liability incurred as a result of my participation in this photography, including any issues incurred as a result.

I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.

Name of Child: ............................................................................................................................................

Name of Parent or Guardian: ........................................................................................................................

Address: ........................................................................................................................................................

.......................................................................................................................................................................

Signature of Parent of Guardian: ........................................................................ Date: .................................