For valuable consideration, receipt of which is hereby acknowledged, I the undersigned parent/guardian of the minor model mentioned below ("Model"), hereby grant the undersigned photographer ("Photographer"), Ciril Mathew Photography & Design LLC, the irrevocable right and permission, throughout the world, in connection with the photographs/digital video he/she has taken of the Model, or in which the Model may be included with others, the following: (a) the right to use and reuse and publish, in any manner at all, said photographs/video, in whole or in part, modified or altered, either by themselves or in conjunction with other photographs/video, in any medium or form of distribution, and for any purposes whatsoever, including, without limitation, all promotional and advertising uses, non-commercial or commercial display, broadcast, exhibition of the final production, and other trade purposes; and (b) the right to copyright said photographs/video in his/her own name or in any other name that he/she may select.

    I waive the right to inspect or approve the finished product or copy and any use thereof.

    I agree that the photographs/digital video, reproductions, and negatives thereof shall constitute the photographer's sole property, and that the photographer has the full right to dispose of any or all of them in any manner whatsoever.

    I hereby forever release and discharge Ciril Mathew Photography & Design LLC, and its clients, from any and all claims, actions and demands arising out of or in connection with the use of said photographs/digital video, including, without limitation, any and all claims for invasion of privacy and libel.

    I have read and understood the terms above. I hereby agree to the terms of this agreement.


    Minor Model Full Name (required): 

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    Parent/Legal Guardian Full Name (required): 

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    I agree to all the terms and have answered all the questions to the best of my knowledge.

    I am the legal guardian and will not take action against the Photographer for any misrepresentation.



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