Model Release Form
AUSTRALIAN INSTITUTE OF PROFESSIONAL PHOTOGRAPHY LTD A.C.N. 050 167 498 A.B.N. 77 050 167 498
AIPP NATIONAL OFFICE: PO BOX 372, NORTH MELBOURNE VICTORIA, 3051 TEL: 1800 686 696 FAX: (03) 9329 9933
THIS FORM MUST BE SIGNED BEFORE ANY PHOTOGRAPHY IS UNDERTAKEN
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Name of Photographer…………………………………….. Job /Series No…………………
Name of Advertising Agency
Or Client (if assignment)…………………………………… Order No. ………………………
Description of Date of
Photography………………………………………………… Photography …………………..
______________________________________________________________________
I permit the photographer named above and his/her licensees or assignees to use the photograph(s)and/or drawings therefrom and any other reproductions or adaptations therefrom either complete or in part alone or in conjunction with any wording and/or drawings for all uses including publicity and/or merchandising and/or editorial purposes in any country. Unless otherwise agreed the photograph(s) and any drawings or adaptations thereof shall be deemed to represent an imaginary person. No changes to the terms of this model release are accepted unless agreed in writing by the photographer, his/her assignees or licensees or myself.
I understand that I do not have any interest in the copyright to the photograph(s) nor shall I receive any further payment.
I am over 18 years old. (Models who are under 18 years of age must provide evidence of consent by a parent or guardian to this model release.)
Name of Model Agency (if any)
……………………………………………………………………………………..…………
Name of Model (capital letters)
…………………………………………………………………….………………………….
Address of Model
…………………………………………………………………………………………..……
Signature of Model ……………………………………………………Date …………………
Signature of Parent or Guardian …………………………………… Date …………………
(if model under 18)
Witness ……………………………………………………………….…Date …………………
This is a basic Model Release. The AIPP suggests you follow your solicitor's advice for your specific requirements.
If you require a PDF version of this Form, Please send me an Email.