Model Release Form For PCOSA 2003 Fashion Show

In consideration of my engagement as a model, and for other good and valuable consideration herein acknowledged as received, I hereby grant to The Polycystic Ovarian Syndrome Association, legal representatives, and assigns, those for whom Photographer is acting, and those acting with his/her authority, and permission, the irrevocable and unrestricted right and permission to take, copyright or otherwise, and use, reuse, publish, and republish photographic portraits or pictures of me or in which I may be included, in whole or in part, or composite or distorted in character or form, without restriction as to charges or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium and in any or all media now or hereafter known for illustration, promotion, art, editorial, advertising, trade, or any other purpose whatsoever. I also consent to the use of any published matter in conjunction therewith.

I hereby waive any right that I may have to compensation or to inspect or approve the finished product or products and the advertising copy or other matter that may be used in connection therewith or the use to which it may be applied.

I hereby release, discharge, and agree to save harmless PCOSA its photographers, legal representatives, and assigns, and all persons acting under his/her permission or authority or those for whom he/she is acting, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said picture or in any subsequent processing thereof, including without limitation any claims for libel or invasion of privacy.

I hereby warrant that I am of full age and have the right to contract in my own name. I have read the above authorization, release, and agreement, prior to its execution, and I am fully familiar with the contents thereof. This release shall be binding upon me and my heirs, legal representatives and assigns.