I
hereby irrevocably consent to the creation of artwork and images
(derived works) by Angel/K. P. Lines derived from photographs
of myself listed on and attached to this Model Release Form. I
authorize the use of these photographs and derived works for any
purpose, both commercial and non-commercial. I further consent
to the reproduction and/or authorization by Angel/K. P. Lines
to reproduce and use said photographs and derived works for use
in all domestic and foreign markets in any medium. Further, I
understand that other and any subsequent reuse for which I shall
receive no compensation, will be sanctioned only by Angel, the
undisputed owner of the derived works.
I hereby release and discharge Angel/K. P. Lines from any and
all claims and demands arising out of or in connection with the
use of the photographs and derived works, including without limitation
any and all claims for libel or invasion of privacy.
I hereby waive any right that I may have to inspect and/or approve
the finished product and any printed material that may be used
in connection therewith, or the use to which it may be applied.
I understand that this Model Release and the submission of my
photographs does not obligate Angel to utilize the photographs
or to return them to me. I understand that if derived works are
generated from my photographs I will receive copies of these derived
works via email as either an image attachment or a link to a web
page where the image can be easily downloaded. I agree that any
use, by myself, of the derived work be limited to personal use
and understand that additional permissions must be granted by
Ange.K. P. Linesl as the copyright owner for any publication,
modification, or public display in any medium.
I affirm that all photographs attached to this Model Release
Form are owned by myself and understand that I am responsible
for any monetary loss and damages as a result of a claim of
copyright ownership by another party. I understand that falsely
representing the attached photographs as my own copyright material
may result in criminal prosecution.
Initial:___________________
I hereby grant Angel/K. P. Linesthe right to use the attached
photographs and derived works in connection with my name as the
model in any display, reproduction, or publication of the derived
work in any medium. (If you circle no you will remain anonymous)
Circle
One: YES NO
I hereby represent that I am over the age of 18 years and have
the right to contract in my own name. I have read and fully
understand the contents of this Model Release prior to its execution.
I declare under penalty of perjury that all of the information
I have given is true and correct.
Date:_____________________ Signature:__________________________________
Full Name:
Address:
Email Address:
Attached Photographs:
File Name:
Short Description:
File Name:
Short Description:
File Name:
Short Description:
File Name:
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