(Company Name Requesting Permission here” 
Model Release/Permission to Use Form
I hereby grant permission to use my likeness in photographs taken by ____________________ , in perpetuity, for the following purpose without financial or other consideration and claim no interest in the property rights of the project containing the image. These photos will only be used to promote _______________________.
To fill out this form: Type will automatically wrap to fit into box.
Model name:  	
Contact Phone Number:  	
Contact mailing address:	
Contact E-mail:  	
Release Signature:	
Project usage description: These photos will only be used to promote_________________________________________________________.	

	
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e-mail: 
Mail:  
c/o 
Phone:
Content Questions: 

Thank you.