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You can get the model release form here for printing with out any graphics.
ADULT RELEASE: LONG FORM
ADULT RELEASE
LONG FORM
In consideration of my engagement as a model,
upon the terms herewith stated, I hereby
give
to David Bigarel his
heirs, legal representatives and assigns, those for
whom David Bigarel is acting, and
those acting with his/her authority and permission:
a) the unrestricted right and permission to
copyright and use, re-use, publish, and republish
photographic portraits or pictures of me or in which I may be
included intact or in part, composite or distorted in
character or form, without restriction as to changes or
transformations in conjunction with my own or a fictitious
name, or reproduction hereof in color or otherwise, made
through any and all media now or hereafter known for
illustration, art, promotion, advertising, trade, or any
other purpose whatsoever.
b) I also permit the use of any printed
material in connection therewith.
c) I hereby relinquish any right that I may
have to examine or approve the completed product or products
or the advertising copy or printed matter that may be used in
conjunction therewith or the use to which it may be applied.
d) I hereby release, discharge and agree to
save harmless David Bigarel, his/her heirs, legal
representatives or assigns, and all persons functioning under
his/her permission or authority, or those for whom he/she is
functioning, 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.
e) I hereby affirm that I am over the age
of majority and have the right to contract in my own name. I
have read the above authorization, release and agreement,
prior to its execution; I fully understand the contents
thereof. This agreement shall be binding upon me and my
heirs, legal representatives and assigns.
Dated:
________________Signed:_____________________________________
Address:__________________________________________________________
City:_____________________________________________________________
State/Zip:__________________________________________________________
Phone:____________________________________________________________
Witness:___________________________________________________________
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