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Authorization To Photograph Release By Subject

[date]

1. Release made by [name and address of party to be photographed] in favor of [name and address of photographer] this [date].

2. Consideration. This Release is being executed by Releasor for the sum of ---------- dollars ($----------) paid by Releasee to Releasor, receipt of which is acknowledged.

3. Subject Matter of Release. The photographer is granted by this Release the right to photograph Releasor, as well as to display, exhibit, [other means, e.g., video rights] those photographs.

4. Release Binding. [Name] (Releasor) releases [name] (Releasee) from any future claims for libel, slander, or any other claim by Releasor against Releasee or Releasee's successors or assigns.

IN WITNESS WHEREOF, Releasor has set Releasor's hand this [date].

[signature]

Releasor