(Company Name Requesting Permission here)
Photo & Model Release/Permission to Use Form
I hereby grant permission to use my photograph and/or my likeness in the following photograph, 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 not be sold and will only be used to promote ____________________________________________________.
To fill out this form: Left click in each text box and type your response. Type will automatically wrap to fit into box.
Contact Person or Photographer:  
(to check information)	
Contact Phone Number:  	
Contact mailing address:	
Contact E-mail:  	
Release Signature:	
Project usage description:	

	
Note:  You must fill out all blanks for each photo submitted. Use a second sheet if necessary.
Name of Photo File	File Format	Photo Resolution
submitted	Add Photographer credits when possible:
	Indicate if photo credit can be on the photo itself or other location	

					

					

Send or email this form and/or images by_____________________DEADLINE to:
e-mail: 
Mailing address:  
c/o 
Phone:
Content Questions: