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Shutterstock Images LLC Model Release For MINOR

This document is a model release form for a minor. It grants the photographer rights to use images of the minor for commercial purposes. It releases the photographer from any liability and requires a parent or guardian's signature. Demographic information about the minor and photographer is also collected.

Uploaded by

Nuchie
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
248 views1 page

Shutterstock Images LLC Model Release For MINOR

This document is a model release form for a minor. It grants the photographer rights to use images of the minor for commercial purposes. It releases the photographer from any liability and requires a parent or guardian's signature. Demographic information about the minor and photographer is also collected.

Uploaded by

Nuchie
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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60 Broad Street . 30th Floor New York .

New York 10004


866.663.3954(p) 347.402.0710(f) www.Shutterstock.com

SHUTTERSTOCK IMAGES LLC


Model Release for MINOR Model Information:

For good and valuable consideration, the receipt and Name (Print): ________________________________________________
legal sufficiency of which is hereby acknowledged,
I ________________________________________________ (“Model”) Address: ____________________________________________________
hereby grant to ____________________________________________ City: __________________________ State: ________________________
and SHUTTERSTOCK IMAGES LLC (collectively, the “Photographer”),
the Photographer’s assigns, and those persons acting with the Photogra- Country: _______________________ Zip/Postal Code: _____________
pher’s authority and permission, the right to take and create photographs/
Phone: __________________ Email: ______________________________
videos and other still and/or moving images, (in all formats) and other
graphical depictions incorporating my likeness, in any and all media, Date of Birth: _________________________________________________
whether now known or hereafter created (the “Content”).
Signature of Parent/Guardian (if minor): ____________________________
I hereby agree that all rights in and to the Content, including the copyright, Date: _______________________________________________________
are and shall remain the sole property of the Photographer, free and clear
from any claims by me or anyone acting on my behalf. Description of Scene: __________________________________________

_____________________________________________________________
The Photographer’s rights include, but are not limited to, the rights,
in perpetuity, to:

Use, re-use, publish, and re-publish the Content; Alter, modify or otherwise
change the Content in any manner the Photographer desires; Combine the Model Ethnicity (Optional):
Content with textual matter and/or with other pictures and/or media; and,
Use the Content for illustration, promotion, art, editorial, advertising, trade, ___ Asian ___ African-American
publishing, or any other purpose whatsoever. ___ Black ___ Caucasian (White)
___ European ___ Hispanic (Latin)
I hereby release, discharge, and agree to hold harmless the Photogra-
___ Middle Eastern ___ Native American
pher, the Photographer’s heirs, legal representatives and assigns, and all
persons acting under the Photographer’s authority or those for whom he/ ___ Pacific Islander ___ Mixed Race
she is acting, from any liability by virtue of any use of the Content or any ___ Other: _____________________________________________
changes or alterations made thereto.

I warrant and represent that I am the father/mother/guardian (circle one) of Visual Reference
______________________________________________, the Model above (Optional headshot or other reference may be included here.
named. I have read the above authorization, release and agreement, Nude imagery requires a driver license)
prior to its execution, and I am fully familiar with the contents thereof.
This release shall be binding upon me and my heirs, legal representatives
and assigns.

Photographer Information:

Name (Print): ___________________________________________________

Address: ______________________________________________________

City: ____________________________ State: ________________________


Witness:
Country: ___________________________ Zip/Postal Code: _____________

Phone: ________________________ Email: __________________________ Name (Print): _________________________________________________

Date of Shoot: ________________________ Medium: Still Video Signature: ___________________________________________________

Signature: _____________________________________________________ Date: ______________________________________________________


Rev. 5/2010

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