Release Form for Models

I, ______________________________________do hereby give Steven G. Chipman, their assigns, licensees, and legal representatives the 
irrevocable right to use my name (or any fictional name), picture, portrait, or photograph in all forms and media and in all manners, including 
composite or distorted representations, for advertising, trade, or any other lawful purposes, and I waive any right to inspect or approve the 
finished version(s), including written copy that may be created in connection therewith. I am of full age.

I have read this release and am fully familiar with its contents.





Date ___________, 20____

Consent (if applicable)

I am the parent or guardian of the minor named above and have the legal authority to execute the above release. 
I approve the foregoing and waive any rights in the premises.


Parent or Guardian_______________________________



Date ___________, 20____