Model Release Form Adult/Minor


I hereby authorize LIVING MOMENTS MEDIA to publish photographs, videos, & cinemagraphs taken of me, and my name, and likeness, for use in LMM's print, online and video-based marketing materials, as well as other publications.  

I hereby release and hold harmless LMM from any reasonable expectation of privacy or confidentiality for myself and/or any minor child and/or children listed below associated with the images specified above.  

I further acknowledge that participation is voluntary and that neither I and/or the minor child or children will receive financial compensation of any type associated with the taking or publication of these visual images or participation in LMM marketing materials or other publications.  

I acknowledge and agree that publication of said media confers no rights of ownership or royalties whatsoever.  I hereby release LMM, its contractors, its employees, and any third parties involved in the creation or publication of marketing materials, from liability for any claims by me or any third party in connection with my participation and/or the minor children listed below.  

IMPORTANT NOTICE REGARDING COPYRIGHT: It is illegal to copy or reproduce the Client's media elsewhere without LIVING MOMENTS MEDIA’s permission, and violators of this Federal Law will be subject to its civil and criminal penalties.  All media, both on LMM’s website, blog or Facebook page, including all potential proofs and purchased prints, are copyrighted, reproduction of any image by any means, including copying, re-printing, screen captures, and other means of print reproduction are strictly prohibited and are a violation of copyright law.  Additionally, it is illegal to post any of LMM’s work on the Internet, blogs, and social networking sites, without the express permission of the creator.  The only exception to this is if you have been given permission or have purchased the print release digital files provided by LMM.

By checking this box and typing my name below, I am electronically signing the model release form. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
Name *
Phone *
Minor Model Release AUTHORIZATION *
Further, I attest that I am the parent or legal guardian of the child or children listed below and that I have full authority to consent and authorize LIVING MOMENTS MEDIA to use their likenesses and names.
I specifically request that Living Moments Media withhold from sharing our photos on their blog, in advertising promotions, or on Facebook, in order to protect our privacy. (This does not include posting photos to an online gallery for the client's personal use and ordering.)