I, _______________________________________, (herein referred to as The Model) for good and valuable consideration, the receipt of which is acknowledged, hereby grant to Erik Werner (herein referred to as Photographer), his legal representatives, successors, and all persons or corporations acting with his permission, unrestricted permission to copyright and/or use, re-use, publish and/or re-publish photographic portraits, pictures, and/or images of me, and the negatives, transparencies, prints, or digital information pertaining to them, in still, single, multiple, moving or video format, or in which I may be included in whole or in part, or composite, or distorted in form, or reproductions thereof, in color or otherwise, made through any media in his studio or elsewhere for art, illustration, promotion, sale, trade, advertising, or any other lawful purpose whatsoever.

I hereby waive any right that I may have to inspect and approve the finished product or copy that may be used in connection with an image that Photographer has taken of me, or the use to which it may be applied. I further release Photographer, or others for whom he is acting, from any claims for remuneration associated with any form of damage, foreseen or unforseen, associated with the proper commercial or artistic use of these images unless it can be shown that said reproduction was maliciously caused, produced and published for the sole purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn and indignity.

I acknowledge that the photography session was conducted in a completely proper and highly professional manner, and this release was willingly signed at its termination. I certify that I am not a minor, and am free and able to give such consent.

The Photographer's signature, hereto attached, provides for me, The Model, the right to use or re-use the same images taken today of myself individually, for the sole purpose of promoting myself, by means of a photographic portfolio, including the internet, personal web sites, e-mail, and any other form of media deemed appropriate for promoting myself as a model, and to use my name in connection therewith if I so choose.

I am of full legal age and have the right to contract in my own name. I have read the foregoing and fully understand the contents thereof. This release shall be binding upon me and my heirs, legal representatives, and assigns, as well as The Photographer.

Date:___________

Model's Signature:____________________________________________

Parent or Guardian (if minor):____________________________________

Date:___________

Photographer's Signature:_______________________________________