Signed in as:
Signed in as:
Thank you for taking a the time to work with me.
PLEASE ONLY SUBMIT THIS FORM IF YOU FULLY UNDERSTAND AND ENTHUSIASTICALLY CONSENT TO WHAT YOU ARE AGREEING TO.
Questions? Contact me directly with any questions you have in advance of submitting this release.
If you are seeing this, it is likely because we either will work together or had worked together already, and I need your permission to publish your amazing content.
Here's the stuff you need to know, followed by an opt-in Model Release agreement below if you wish to have our work together published and shared with the Galaxy.
ELECTRONIC MODEL RELEASE AGREEMENT FOLLOWS -->
This Model Release Form relates to the use of personal media and images utilized for an artistic or commercial endeavor by and between Rick Broider LLC ("Producer") and you, ("You", "Your" "Model"), the individual submitting this form.
In consideration of your engagement as a model, and for good and valuable consideration in exchange, the receipt of which you hereby acknowledged, Model absolutely and irrevocably authorizes Rick Broider LLC, as well as their legal representatives, assignees, and transferees to use, publish, reuse, republish, distribute, disseminate or otherwise make publicly available for any artistic or commercial use, including advertising, publication, or illustration images and recordings of me and/or my property, of the following description:
Recordings, captures taken on in whole or in part featuring Model's image, voice, property, energy, topics, concepts or ideas (collectively "Materials"), whether taken individually or collectively with any other material, in any and in all forms of media now or hereinafter known and/or developed, including, but not limited to, in print media, in digital media, on the Internet, in composite images, or distorted images or for any other lawful use as may be determined by in their sole and exclusive discretion, including the use of Model's name without restriction. Producer shall specifically be permitted to use fictitious names in conjunction with any published materials featuring Model.
Depending upon the nature of the capture session, Model specifically acknowledge and agrees that some captured materials may include vulgar language, and /or full or partial nudity. Model hereby consents and agrees to appear uncensored, and fully or partially nude in the work, if applicable.
MODEL WAIVES ANY AND ALL RIGHTS AND CLAIMS FOR ADDITIONAL COMPENSATION WITHOUT SEPARATE MUTUAL AGREEMENT. MODEL ALSO WAIVES ANY AND ALL RIGHTS TO APPROVE OR OTHERWISE REVIEW ANY MATERIALS.
This authorization and release shall inure to the benefit of the legal representatives, licensees, heirs and assignees of and shall also be binding upon Model, Model's heirs, assignees, and legal representatives.
Model further completely releases and discharges Producer from any and all demands or claims that may arise out or any and all claims that may otherwise be connected with the use of the photographs featuring Model, including, without limitation, and any all claims for the violation of a right of publicity, a right of privacy, or libel.
BY SUBMITTING THIS ELECTRONIC FORM, YOU SWEAR THAT
UNDER 28 U.S.C.1746 AND THE PENALTIES OF PERJURY UNDER THE LAWS OF THE UNITED STATES,
MODEL SWEARS THAT THE INFORMATION SUBMITTED BELOW WITH THS ELECTRONIC AGREEMENT IS TRUE AND CORRECT.