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For
good and valuable consideration, the receipt and legal sufficiency
of which is hereby acknowledged, I ___________________________________
("Model") hereby grant to ____________________ and
LiteFocus. (Collectively, the "Photographer"), the
Photographer's assigns, and those persons acting with the
Photographer's authority and permission, the right to take
and create photographs (in all formats) and other graphical
depiction's incorporating my likeness, in any and all media,
whether now known or hereafter created (the "Photographs").
I
hereby agree that all rights in and to the Photographs, including
the copyright, are and shall remain the sole property of the
Photographer, free and clear from any claims by me or anyone
acting on my behalf.
The
Photographer's rights include, but are not limited to, the
rights, in perpetuity, to:
Use, re-use, publish, and re-publish the Photographs;
Alter, modify or otherwise change the Photographs, in any
manner the Photographer desires;
Combine the Photographs with textual matter and/or with other
pictures and/or media; and,
Use the Photographs for illustration, promotion, art, editorial,
advertising, trade, publishing, or any other purpose whatsoever.
I hereby release, discharge, and agree to hold harmless the
Photographer, the Photographer's heirs, legal representatives
and assigns, and all persons acting under the Photographer's
authority or those for whom he/she is acting, from any liability
by virtue of any use of the photographs or any changes or
alterations made thereto.
I
hereby warrant that I am of full legal age and have the right
to contract in my own name. I have read the above authorization,
release, and agreement, prior to its execution, and I am fully
familiar with the contents thereof. This release shall be
binding upon me and my heirs, legal representatives, and assigns.
Name (Print)__________________________ Date ___________________
Signature
____________________________ Phone _________________
Address
_____________________________________________________
City
_________________________________ State ____ Zip __________
Witness
Sign ______________________________________________
Witness
Print ______________________________________________
Photo
IDs:_________________________________________________
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