Model Release Form

For valuable consideration received, I grant to Jordan smith ("Photographer") and his/her legal
representatives and assigns, the irrevocable and unrestricted right to use and publish
photographs of me, or in which I may be included, for editorial, trade, advertising, and any
other purpose and in any manner and medium; and to alter and composite the same without
restriction and without my inspection or approval. I hereby release Photographer and his/her
legal representatives and assigns from all claims and liability relating to said photographs.

Pippa Lovell PRINT NAME

21/11/2014 MODEL’S DATE OF BIRTH

24, Canberra House, Pitman Road, Cheltenham, Gloucestershire 1st LINE OF ADDRESS

GL51 7UB POSTCODE

10/12/2020 TODAY’S DATE

L Smith. LEGAL GUARDIAN SIGNATURE (if under 18)

Larissa Smith PRINT NAME

10/12/2020 TODAY’S DATE