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DTX Media Model Release - 2020 v2

DTX Media Model Release

In consideration of my engagement as a model/ actor, and for other good and valuable consideration herein acknowledged as received, I hereby grant to DTX Media, LLC, it's employees or contract photographers / videographers, it's owner, it's legal representatives and assigns, those for whom photographer / videographer is acting, it's clients and it's client's clients, the irrevocable and unrestricted right and permission to copyright, in his/her own and or the company name, to use, re-use, publish, and re-publish photographic pictures or video of me or in which I may be included, in whole or in part, or composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium at on shoot location or elsewhere, and in any and all media now or hereafter known for illustration, promotion, art, editorial, advertising, trade, or any other purpose whatsoever. I also consent to the use of any printed matter in conjunction therewith and hereby waive any right that I may have to inspect or approve the finished product or products and the advertising copy or other matter that may be used in connection there- with or the use to which it may be applied.*

I agree

Model's Full Legal Name*

Model Birth Date*

Is Model 18 years of age or older?*

Yes

No

Guardians Name (if under 18)

Email*

Phone

Address

Additional Information or Terms (Optional)

Image / Visual Reference (selfie, license pic, headshots, etc)

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Signature*

Today's Date*

By submitting the above form, I hereby release, discharge and agree to save harmless DTX Media, LLC all persons acting under it's permission or authority or those for whom it is acting, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said picture or in any subsequent processing thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy.*

I agree

 

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