Chromatrance

Model Release

Chromatrance Photography
13 Duncan Drive
Billerica, MA 01821-6179

Adult Model Release

For valuable consideration received, I hereby grant to Chromatrance Photography, and its legal representatives
and assignees, the right to use and publish digital images of me, or in which I may be included, for editorial,
trade, advertising, and any other purposes; in any manner and medium; to alter the same without restriction; and to copyright the same.

I hereby release Chromatrance Photography, its legal representatives, and assignees from all claims and liabilities
relating to said digital images.

I acknowledge that all digital media remain the copyrighted property of Chromatrance Photography, and will not
duplicate in any manner without express written permission from Chromatrance Photography.

This release shall apply to all photographic sessions conducted with me by Chromatrance Photography, whether past, present, or
future, unless and until I revoke this release in writing.

Model information

Name: ________________________________

Birthday: __________________ Age: ______

Address: ________________________________

City/State: _____________________________

Email: _________________________________

Signature: ______________________________

Date: _________________________________