Model Release Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Talent's Name *FirstLastDate of Photo / Video Shoot *Location of Photo / Video Shoot *Talent's Date of Birth *Talent's Phone NumberTalent's AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateGuardian's ConsentI am the parent and/or the legal guardian of the above-mentioned person. I hereby approve the forgoing consent of the above-mentioned company to use, subject to the terms mentioned below.Guardian's Name *FirstLast Talent's / Phone Guardian Date of Birth *Guardian PhoneGuardian's Address If DifferentAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateConsent Authorization * *I hereby authorize Greenfields Outdoor Fitness, Inc. to use my photographs and/or video images reproduction and/or likeness in any medium for the purpose of instruction, education, advertising, display, print, exhibition, video, commercial, website and/or editorial use. I authorize the unlimited use and reproduction of any and all photographs and other materials. I understand all such photographs and related materials are and will forever remain the sole property of Greenfields Outdoor Fitness, Inc.Submit
