Model Release Form

MODEL RELEASE

THIS MODEL RELEASE FORM (hereinafter "Release") is dated..............................................

PUBLISHER DETAILS (hereinafter "Publisher"):

Publisher name: ________

Publisher address:

________

MODEL DETAILS (hereinafter "Model"):

Model name: ________

Model address:

________

(1) BACKGROUND

(a) The Publisher and the Model have agreed for the Publisher to produce photographs of the Model ("Work").

(b) The Model consents to the Publisher using the Model's image in order to produce the Work, and the Model acknowledges that all right title and interest in the Work will be the property of the Publisher, on the terms set out in this Release.

(c) The Publisher agrees to produce the Work in consideration for the Model's agreement to be bound by the terms of this Release. In consideration of the mutual benefits and obligations set out in this Release, the Publisher and the Model agree as follows:

(2) CONSENT, ACKNOWLEDGEMENT AND RELEASE

By signing this Release, the Model hereby:

(a) consents and agrees to the Publisher, together with any officers, employees, directors, agents, contractors, assignees, licensees, transferees, successors, legal representatives or other representatives of the Publisher ("Publisher's Representatives"), photographing the Model and using any image(s) of the Model and any derivative works in any way the Publisher or any of the Publisher's Representatives determine in their absolute discretion; and

(b) consents to the publication of the Model's name together with the Work; and

(c) consents to the use of fictitious names together with the Work; and

(d) acknowledges that all right, title and interest in or relating to any Work belongs to the Publisher absolutely; and

(e) irrevocably and unconditionally releases and discharges the Publisher, together with any of the Publisher's Representatives, from any and all claims, debts, demands, suits, actions, proceedings or other liabilities whatsoever (including any costs whether legal or otherwise) which the Model may have at any time arising in connection with the Publisher's use of the Work.

(3) WORK

The Work, to which this Release relates, specifically includes the following:

________

(4) CONFIRMATION

The Model hereby confirms that:

(a) the Model is over the age of eighteen (18) years and has the right to contract in the Model's own name; and

(b) the Model has read this Release prior to signing it; and

(c) the Model fully understands the contents of this Release; and

(d) the Model intends for this Release to be binding on the Model, together with the Model's heirs, assigns, and legal representatives.

(5) 58885258 82 852855

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(6) GOVERNING LAW

This Release shall be governed in all respects by the laws of New South Wales and any applicable federal law.

EXECUTED AS AN AGREEMENT

Executed by ________ in accordance with s127 of the Corporations Act 2001 (Cth) by:

..............................................
Signature of first director

..............................................
Name of first director

..............................................
Signature of second director

..............................................
Name of second director

Executed by the Model ________

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________