1. For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby grant to Client (as defined below), its agents (including, without limitation, _________ ), and others working for it or on its behalf, and their respective licensees, successors, and assigns (collectively, the "Licensed Parties"), the right and permission to use my name, signature, picture, likeness, voice, social media handles, avatars, and biographical information, and any material based thereon or derived therefrom, together with any actual or fictional material, for advertising, promotion, and publicity purposes, in accordance with the terms and conditions set forth below. In addition, at any time during and after the Term (as defined below), the Licensed Parties may use the materials produced hereunder anywhere in the world at sales meetings and for intra-company, research, award, publicity (including, without limitation, on their websites), file, and reference purposes.
  2. I hereby waive any right to inspect and approve the materials produced hereunder, their use, or such copy or other materials as may be used in connection therewith. I understand that nothing contained herein shall obligate the Licensed Parties to make any use of the materials produced hereunder or the rights granted herein. Other than as may be set forth below, I shall have no right of approval, no claim to additional compensation, and no claim (including, without limitation, claims based upon invasion of privacy, defamation, or right of publicity) arising out of any use, blurring, alteration, distortion, illusionary effect, faulty reproduction, fictionalization, or use in any composite form of my name, signature, picture, likeness, voice, social media handles, avatars, and biographical information. I shall not make any mention of any of the Licensed Parties or any of their products or services in a derogatory manner, and I shall not use or disclose (including, without limitation and by way of example, via text messaging, blogging, or communicating in any way via Twitter, Facebook, Instagram or any other social networking website, tool, or device, etc.) any of their trade secrets or confidential information (including, without limitation, the terms of this agreement). Any materials placed during the Term which may remain on display or in circulation following the expiration of the Term shall not give rise to a claim against the Licensed Parties, provided, however, that the Licensed Parties shall not place any additional materials produced hereunder in any media (other than as permitted herein) following the expiration of the Term.
  3. I represent and warrant that I am over 21 years of age (or if under 21 my parent or legal guardian will sign below to signify agreement to the terms and conditions of this agreement). I also represent and warrant that I have the right to enter into this agreement and have no conflicting commitments or obligations that would interfere with my ability to perform the services required of me and the rights herein granted. I agree that the Model Agency set forth below is my employer. I have not authorized (which authority is still in effect) nor will I authorize or permit the use during the Term of my name, signature, picture, likeness, voice, or biographical information in connection with the advertising, promotion, or publicity of any product or service which is competitive to or incompatible with those of Client. This agreement contains the entire understanding between the parties with respect to the subject matter hereof, supercedes all prior agreements with respect to the subject matter hereof, and may not be altered or waived except by a writing signed by both parties. This agreement shall be governed by the laws of the State of New York applicable to contracts executed and to be fully performed therein.


Length of use ("Term") from date of first public appearance in any Media:



Shoot dates:




Additional terms:


Job No.: _____________________________


Date: _______________________________


Client: ______________________________

Name (please print):



as agent for the above-named Client

Phone no.:

Social Security no.:


Model agency:

                Authorized Officer


                                                                     Parent/Legal Guardian