Model Release Form Photographer: Antje Kastner-Panya For valuable consideration, I hereby irrevocably consent to and authorize the use and the reproduction by you, or anyone authorized by you, of any and all photographs which you have this day taken of me, negative or positive, proofs of which are hereto attached, for any purpose whatsoever, without further compensation to me. All negatives and positives, together with the prints shall constitute your property, solely and completely. These images may be used by me for personal and family use without additional written consent provided that they are appropriately and clearly credited to Antje Kastner Studio.These images may NOT be used by me for publication, profit, sale, or competition without a written consent (and royalties, and/or recognition, if required) in the form of an addendum to this agreement. Date of Photoshoot MM DD YYYY Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Website (if applicable) http:// Are you over 18? * Yes No (If you are under 18, please have a parent or guardian sign below) Parent/Guardian Name (if applicable) First Name Last Name Today's Date MM DD YYYY Thank you!
