Model Release
For valuable consideration received, I hereby give “D.J. La Sha” the absolute and irrevocable right and permission, with respect
to the photographs that he has taken of me or in which I may be included alone or with others:
a. To copyright the same in his own name or any other name that he may choose.
b. To use, re-use, publish the same in whole or in part, individually or in conjunction with other photographs, digitally altered or
altered in other ways, in any medium and for any purpose whatsoever, including (but not by way of limitation) illustration,
promotion and advertising and trade and Internet display, and
c. To use my name in connection therewith if he so chooses.
I hereby release and discharge “D.J. La Sha” from any and all claims and demands arising out of or in connection with the use
of the photographs, including any and all claims for libel.
This authorization and release shall also endure to the benefit of the legal representatives, licensees and assignees of “D.J. La
Sha” as well as, the person(s) for whom he took the photographs.
I am over the age of eighteen. I have read the foregoing and fully understand the contents thereof.
Signed: ___________________________________________
Date: ___________________________________________
Witnessed: ___________________________________________
If under 18, signature of parent or guardian is required.
Signature of Parent or Guardian: __________________________