Model Release

PHOTO RELEASE ___Model(s)  ___Animal(s) ___Property

For valuable consideration received, I herby grant to                         Lisa Loucks-Christenson the Photographer, and her legal representatives and assigns, successors, the irrevocable and unrestricted right, in perpetuity, to use and publish photographs of me, my animal, my property, and any photos of me in which I may be included: for editorial, trade, advertising and any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same, without my approval of images. I hereby release Photographer, Lisa Loucks-Christenson, and her legal representatives and assigns, successors, from all claims and liability relating to said photographs.

Name_________________________Date____________

Signature________________________________________

Tel.(______)________-__________

E-Mail______________@___________

Address_______________________________

City_____________ ST______ Zip_____________

If Minor, Signature of Parent/Guardian____________________________________

Witness________________________________

Date: ______________________________

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Office:
Date of Shoot:___________________________
Photo Project:___________________________
Exchange________________________________

Catalog ID_________________________

Tearsheet__________________________

Mailing address: Lisa Loucks-Christenson, P.O. BOX 9177, Rochester, MN 55903