Model Release Form - Lapalme Magazine

1. For valuable consideration, the adequacy of which is acknowledged, for your photographing me, and knowing that you have and will expend substantial expenses and time in reliance upon this Release and Consent, I irrevocably and absolutely consent to the unrestricted use by the photographer named below and LAPALME MAGAZINE and its heirs, successors, assigns, and designees, and those acting with Photographer’s permission and authority, of my name and any and all photographic or other images (“Images”) of me that Photographer or Publisher creates or makes, for all purposes, in any form, in conjunction with my own or a fictitious name, and in any and all media, including, without limitation, advertising, art, promotion, solicitation, or trade.

2. I waive any right to inspect or approve the finished Images, advertising copy, text, or other printed matter that may be used in conjunction therewith, or to the eventual use that the Images may be applied.

3. I release and discharge the Photographer, Publisher and those acting with the Photographer’s authority from any and all liabilities, claims and demands arising out of or relating to any blurring, distortion, use in composite form, or alteration whether intentional or otherwise, that may occur or be produced in connection with the Images, or in connection with any processing, alteration, transmission, display, publication or other use of the Images.

4. I hereby forever release and discharge the Photographer, Publisher and those acting with the Photographer’s authority, his heirs, legal representatives, agents, assigns and the party for whom the photographs were made, from any and all claims, actions and demands arising out of or in connection with the use of said Images, including without limitation, any and all claims for invasion of privacy and libel.

5. This Agreement constitutes the sole, complete and exclusive agreement between the Photographer, Publisher and those acting with the Photographer’s authority and me regarding the Images and I am not relying on any other representation whether oral or written.

6. I hereby affirm that I am over the age of consent and have the right to contract in my own name. I have read the above authorization, release and agreement, prior to its execution; I fully understand the contents thereof. This agreement shall be binding upon me and my heirs, legal representatives and assigns.

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