Transcription of Photo/Video Authorization and Release
1 _____ Photo/Video Authorization and Releaseby Documatica Legal Forms I, Janet Smith, of 198 Birch St., Seattle Washington, 37462 in consideration of mychild's engagement as a model, authorize Scott Adams (the Photographer ), to use: 1. film photographs2. digital photographs3. motion picture footage4. audio recordings of my child (the Materials ) in accordance with the following terms: THEME OF MATERIALS The Materials will be recorded and used with the understanding that the content ortheme thereof will be the following: Black and white photographs of children on stepsof heritage buildings. LOCATION The Materials will be recorded at or around the following location(s): Art Gallery, 20911th St., Seattle, Washington SCHEDULE The approximate time during which the Materials will be recorded is: August 11-18,2007 Copyright (c) 2007 Used under license by Documatica Legal Forms 1 REPRODUCTION AND USE Scott Adams has the unrestricted right and permission to copyright and use, re-use,publish, and republish the Materials in all forms of media (including printed materials)for art, promotional purposes (including, but not limited to, advertising, publicity,commercial, or display use), illustration, exhibition, editorial, trade, or any otherpurpose whatsoever.
2 This right extends to both domestic and foreign markets. Release OF CLAIMS I hereby relinquish any right that I may have to examine or approve the completedMaterials or their use(s). Further, I hereby Release and discharge Scott Adams and all persons functioning underhis/her permission or authority (including, but not limited to, associates, affiliates,officers, agents, advertising agencies, designated directors, employees, andcustomers) from any claims. This includes claims related to blurring, alteration,distortion, or use in composite form that may occur or be produced in the process ofrecording, processing, or publishing the Materials, including any claims for libel orinvasion of privacy. I have read the foregoing and fully understand the contents hereof. I represent that Iam the parent or guardian of the above named model. For value received, I herebyconsent to the above on his/her behalf.
3 Dated: July 16, 2007 Minor's Name: Anne Mary SmithParent or Guardian: Janet Smith 198 Birch St.,Seattle Washington, 37462 Phone: 203-833-7264 Witness:_____Copyright (c) 2007 Used under license by Documatica Legal Forms 2
