Permission for Photography of a Minor Child

For valuable consideration received, I grant to O. Brad Allen ("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.

*Photo Session - $50 per hour *Touch-up $50 per hour

When determining Touch-up hours use this as a guide: Heavy edit 4/hr., Quick edit 10/hr.

Touch-Up: Please Check One O Heavy 4/hr O Medium 6/hr. O Light 10/hr.

THE AGREED UPON AMOUNT OF THE SERVICE IS -  Session Hour(s) ______ Total Hours _______ @ $50/hr. = $_________

Touch-Up: Please Check One O Heavy 4/hr O Medium 6/hr. O Light 10/hr. Touch-up hour(s) ______@ $50/hr. ______

Number of Prints _____ Total Cost $ __________

IN RETURN FOR PHOTOGRAPHS TAKEN ON

Date:  _________________________________ AT (Location) __________________________________________________

SIGNATURE OF CHILD

..............................................................................................................................................

PRINT NAME ____________________________________________

DATE OF BIRTH__________________________________________

HOME ADDRESS

_______________________________________________________

_______________________________________________________

SIGNATURE OF PARENT/GUARDIAN (required) ...................................................................................................

(Parent/Guardian must be present at photography session or the session will NOT take place.)

This section is to be filled out on the day of the Photography Session.

TODAY'S DATE................................................................................................................................

WITNESS (Print Name)....................................................................................................................

ADDRESS (Line 1)..............................................................................................................................

ADDRESS (Line 2)...............................................................................................................................

SIGNATURE OF WITNESS..............................................................................................................................................

 O I have read this model release form carefully and fully understand its meanings and implications.

Please check and Initial here. _________.