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Leeton Agency Model Release

Photographer’s name .................................................................................................................................

Hereafter named “The Photographer”

Model’s name .............................................................................................................................................

Model’s telephone number/s....... Agent 07 3311 2395 .........................................................................

Model’s email address…… artmodels@leetonagency.com.au …………….....................................………

In consideration of…………………………………(amount / nil / prints), in return for posing for

photographs taken by “The Photographer”

on:…………………............................………… at ...……………………………….…………………...............

………………………………………………………………………...............................................…………......

By signing this release I hereby assign full copyright of these photographs to "The Photographer"

I give “The Photographer” and Assigns my permission to license, with restricted use, the Images for the purpose
of self promotion, exhibitions, fine art prints and stock imagery.

The photographer and those acting with the photographer’s permission, agree the images of the model in whole
or in part are not to be used in conjunction of any pornographic, defamatory, libellous, violence or illegal/illicit
activities.

No images taken are to be placed on the internet without the Model’s permission.

I agree that the Images may be combined with other images, text and graphics, and cropped, altered, retouched
or modified. I agree that I have no rights to the Images, and all rights to the Images belong to the Photographer
and Assigns. I acknowledge and agree that I have no further right to additional Consideration or accounting, and
that I will make no further claim for any reason to Photographer and/or Assigns. I acknowledge and agree that this
release is binding upon my heirs and assigns. I agree that this release is irrevocable, worldwide and perpetual,
and will be governed by the laws of Australia, excluding the law of conflicts.

I consent to the inclusion of this Model Release form including the personal details being submitted to Assigns and
Licensees with the images when required.

I have read the Model release form carefully and fully understand its meanings and implications.

To be completed by the Model

Date ...........................................

Model’s signature ............................................................................................................

Model’s printed name ......................................................................................................

Model’s date of birth ........................................................................................................

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Leeton Agency Model Release

Important!

If the Model is under 18 year of age (a minor), a parent or legal guardian must also sign this
release:

Date ..............................

Delete as applicable......................Parent / Legal Guardian

Printed name ...................................................................................................................

Signature ..........................................................................................................................

Model’s date of birth .........................................................................................................

To be completed by the Photographer

Photographer’s name .......................................................................................................

Shoot date ........................................................................................................................

Photographer’s signature .................................................................................................

Definitions

• “Assigns” means a person/company to whom “The Photographer” has assigned or licensed rights
under this release as well as the licensees of any such person or company.
• “Consideration” means something of value I have received in exchange for the rights granted by
me in this release.
• “Images” means all photographs taken of the model as part of the Shoot.
• “Media” means all media including digital, electronic and prints.
• “Model” means you, the model, and includes your appearance, likeness and form.
• “Shoot” means the photographic session described in this form.