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M O DE L RE LEASE FOR M I hereby allow my photograph to be taken for use in NE H MAGAZ I N E . Taking into consideration the terms and conditions below, I give my permission, with no compensation given, offered, promised or expected, to allow NE H MAGAZ I N E or anyone acting on their behalf;

a) The unrestricted right and permission to copyright and use, re-use, publish and republished photographic portraits 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 my own or a fictitious name, or reproduction hereof in color of otherwise, made through any and all media now or hereafter known for illustration, art, caricature, promotion, advertising, trade, or any other purpose whatsoever.

b) I will also allow all forms of printed or electronic media to be used with respect to these terms and conditions.

c)

I give up any rights I have to approve or examine the finished material or any advertising products that may be used in conjunction therewith or the use to which it may be applied.

d) I hereby release N E H MAGAZ I N E , and their legal representatives or assigns, and all persons functioning under their permission or authority, for those for whom he/she is functioning, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite from whether intentional or otherwise, that may occur or be produced in taking 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 eighteen (18) years of age and have the right to contract in my own name. I have read the above authorization, release and agreement, prior to its execution; I full understand the contents thereof. This agreement shall be binding upon me and my heirs, legal representative and assigns.

f)

I shall not attempt to use, reproduce or otherwise publish, electronically, in print or for personal use any photos baring or including my likeness without the signed authorization of the N E H MAGAZ I NE Creative Director or his/her designate.

g) I recognize, understand and agree that English shall be the governing language of this agreement.

Signature: _____________________________________Date: _____________________ Printed Name: _________________________________ Phone: ____________________ Street Address: ________________________________________________________________ City: ______________________________

Email Address: ____________________________

Witness: _____________________________________ Alien Card #: ____________________ * This release shall be kept on record for one year following the taking of any and all photos.

MODEL RELEASE FORM  

Printed Name: _________________________________ Phone: ____________________ Street Address: ________________________________________________...

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