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Dallas Video Production and Photography | DFW Dallas / Fort Worth | 214-810-5570
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DTX Media Model Release - Updated Fall 2022
DTX Media Model Release
In consideration of my participation and or engagement in this production as a model, actor, voice actor, spokesperson, extra or any other performance, I hereby grant to the 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 “Producer”), 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, video, audio, or other media capture of me, in which I may be included, in whole or in part, or composite or distorted in character or form. The Producer may distribute without restriction as to changes or alterations, in conjunction with my own or a fictitious name, my testimonial or story, made through any medium and in any and all media now or hereafter known for illustration, promotion, art, editorial, advertising, sale, trade, or any other legal purpose whatsoever. I understand there will be no royalties and or restrictions in how the media which reflects my likeness is distributed, which includes but is not limited to film, video, printed or published 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.
Model's Full Legal Name
Model Birth Date
Is Model 18 years of age or older?
Guardians Name (if under 18)
Additional Information or Terms (Optional)
Image / Visual Reference (selfie, license pic, headshots, etc)
Signature (Guardian must sign if participant is under 18)
By submitting the above form, I hereby release, discharge and agree to save harmless the Producer 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.
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