Model Release

2010 Mezzato Inc., Cutcaster – www.cutcaster.com

Model Release
I am the exclusive owner of all right, title and interest in and to my image, signature, voice and likeness, and other rights of publicity in and to my name, image, likeness, voice, signature and other elements of my persona and identity (collectively, the "Image" or "Images"). For good and valuable consideration, the sufficiency of which is hereby acknowledged, I irrevocably grant the Videographer named below and their heirs, assigns and licensees the unrestricted, royalty-free and worldwide right to copyright, use, reuse, publish and republish, publicly display, create derivative works of, reproduce and to authorize others to use, without restriction as to changes, distortion or transformation any of the Images including the right to use and exploit in any and all media my name and Image, as it appears in any and all videos and/or photographs produced by Videographer. In consideration of my signing this Release, the Videographer will use reasonable efforts to ensure that the Images will not be used for any obscene or pornographic purpose. I relinquish any rights, to review or approve of the Images and release Videographer and his heirs, assigns, licensees and all persons or entities using the Images with his permission or to whom the Images are provided for sale or resale from any and all liability regarding use of the Images. This Release may not be amended or modified except by a written agreement executed by the parties hereto or their respective successors and legal representatives. This Release is assignable by the Videographer without my consent. The invalidity or unenforceability of any provision of this Release shall not affect the validity or enforceability of any other provision of this Release. If any provision of this Release shall be held invalid or unenforceable in part, the remaining portion of such provision, together with all other provisions of this Release, shall remain valid and enforceable and continue in full force and effect to the fullest extent consistent with law. By signing below (check one): I represent that I have read this Release, that I am of legal age and that I understand that this Release is binding without any restrictions on use and is binding on my heirs, legal representatives and assigns. I represent that I am the parent or legal guardian of the Model who is a minor and that I have read this Release, and that I understand that this Release is binding without any restrictions on use.

Notes: (Please insert particulars of consideration or other relevant information)
©2010 Mezzato, Inc., Cutcaster – www.cutcaser.com

MODEL:

Name (print) ______________________
Signature ____________________________
Date _________________________________
Phone ________________________________
Address ______________________________
City _________________________________
State/Province _______________________
Zip/Postal Code ______________________
Country ______________________________
Email ________________________________

PHOTOGRAPHER:

Name (print) ______________________
Signature ____________________________
Date _________________________________
Phone ________________________________
Address ______________________________
City _________________________________
State/Province _______________________
Zip/Postal Code ______________________
Country ______________________________
Email ________________________________

WITNESS: (NOTE: All persons signing and witnessing must be of legal age and capacity in the area in which this Release is signed. A person cannot witness their own release)

Name (print) ______________________
Signature ____________________________
Date _________________________________

PARENT(S) or GUARDIAN(S): (Required only if Model is a minor or lacks capacity in the jurisdiction of residence)

Name (print) ______________________
Signature ____________________________
Date _________________________________
Phone ________________________________
Address ______________________________
City _________________________________
State/Province _______________________
Zip/Postal Code ______________________
Country ______________________________
Email ________________________________