Model Release Form

 I,__________________________, hereby grant Your Goddess Art, LLC

          (model’s name)                                                  

 And legal representatives irrevocable permission to use photographs of me and derivative works based thereupon for all lawful purposes subject to the terms and conditions described herein.  These images may be published in any manner.  I will hold harmless the aforementioned photographer and his/her legal representatives and assigns, from any liability regarding modifications to the images unless it can be proved they were made and published maliciously. 

 Model hereby affirms that all poses and situations enacted in the Photos were entered into with Model’s full consent and without use of force or threats.  Model affirms that he/she is 18 years or older and that Model is fully able to contract in his/her own name without breach of any prior agreement or applicable law.

 Model’s Name/Signature/Date__________________________________________ 

 Model’s Address_____________________________________________________

 Release by Parent/Guardian of Minor Child

 I am the parent or legal guardian of the minor named above, and have legal authority to execute this release on his/her behalf.  I have read and fully understood the contents of this release, and consent to the use of said photographs.

Parent/Legal Guardian Name/Signature/Date_________________________________________________

Please send this signed form to PO Box 4121 , Medford OR 97501