
MODEL  RELEASE:

	I,  (Please Print)_______________________________("Model"), 
for good and valuable consideration, the receipt of which is 
acknowledged, give to XYZ Video ("PRODUCER"), its legal 
representatives, successors, and all persons or corporations 
acting with its permission, unrestricted permission to 
copyright and/or use, and/or publish photographic portraits 
or pictures of the Model, and the negatives, transparencies, 
prints, or digital information pertaining to them, in still, 
single, multiple, moving or video format, or in which the 
Model may be included in whole or in part, or composite, 
or distorted in form, or reproductions thereof, in color or 
otherwise, made through any media in photographer's studio 
or elsewhere for art, or any other lawful purpose.  

       I hereby waive any right that I may have to inspect 
and approve the finished product or copy that may be used 
in connection with an image that CCI has taken of the Model, 
or the use to which it may be applied.

       I further release PRODUCER, or others for whom PRODUCER 
is acting, from any claims for remuneration associated with 
any form of damage, foreseen or unforeseen, associated with 
the proper commercial or artistic use of these images unless 
it can be shown that said reproduction was maliciously caused, 
produced and published for the sole purpose of subjecting the 
Model to conspicuous ridicule, scandal, reproach, scorn and 
indignity.

       I acknowledge that the videotaping/photography session
was conducted in a completely proper and highly professional
manner, and this release was willingly signed at its termination.
I certify that I am not a minor, and am free and able to give 
such consent.



______________________________              ____________________
Model's signature                            Date

________________________________________     ____________________                        
Home address                                 Home telephone number
                                               


                                _________________________________
                                 (Witness)




This form will be retained with the videotapes, negatives, transparencies,
and/or contact sheets.			
