Revision: 20110207_235010 | All Revisions
In exchange for consideration received, I hereby give permission to ____________________________________________________ to use my name and photographic likeness in all forms and media for advertising, trade, and any other lawful purposes.
Print Name: __________________________________________________
Signature: ___________________________________________________
Date: ________________________________________________________
If Model is under 18:
I, _____________________________________________________, am the parent/legal guardian of the individual named above, I have read this release and approve of its terms.
Print Name: __________________________________________________
Signature: ___________________________________________________
Date: ________________________________________________________
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