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350 Fifth Avenue, 21st Floor

New York, NY 10018, USA


p 855.272.5125 f 212.242.3734
b i g s t o c k .c o m

BIGSTOCK
Model Release for MINOR Model Information:

For good and valuable consideration, the receipt and Name (Print): ________________________________________________
legal sufficiency of which is hereby acknowledged,
I ________________________________________________ (“Model”) Address: ____________________________________________________
hereby grant to ____________________________________________ City: __________________________ State: ________________________
and SS SPV LLC d/b/a BIGSTOCK (collectively, the “Photographer”),
the Photographer’s assigns, and those persons acting with the Photogra - Country: _______________________ Zip/Postal Code: _____________
pher’s authority and permission, the right to take and create photographs/
Phone: __________________ Email: ______________________________
videos and other still and/or moving images, (in all formats) and other
graphical depictions incorporating my likeness, in any and all media, Date of Birth: _________________________________________________
whether now known or hereafter created (the “Content”).
Signature of Parent/Guardian (if minor): __________________________
I hereby agree that all rights in and to the Content, including the copyright, Date: _______________________________________________________
are and shall remain the sole property of the Photographer, free and clear
from any claims by me or anyone acting on my behalf. Description of Scene: __________________________________________

_____________________________________________________________
The Photographer’s rights include, but are not limited to, the rights,
in perpetuity, to:

Use, re-use, publish, and re-publish the Content; Alter, modify or oth -
erwise change the Content in any manner the Photographer desires;
Combine the Content with textual matter and/or with other pictures and/ Model Ethnicity (Optional):
or media; and, Use the Content for illustration, promotion, art, editorial,
advertising, trade, publishing, or any other purpose whatsoever. ___ Asian ___ African-American
___ Black ___ Caucasian (White)
I hereby release, discharge, and agree to hold harmless the Photogra - ___ European ___ Hispanic (Latin)
pher, the Photographer’s heirs, legal representatives and assigns, and all ___ Middle Eastern ___ Native American
persons acting under the Photographer’s authority or those for whom he/ ___ Pacific Islander ___ Mixed Race
she is acting, from any liability by virtue of any use of the Content or any
changes or alterations made thereto. ___ Other: _____________________________________________

I warrant and represent that I am the father/mother/guardian (circle one) of Visual Reference
______________________________________________, the Model above (Optional headshot or other reference may be included here.
named. I have read the above authorization, release and agreement, Nude imagery requires a driver license)
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.

Photographer Information:

Name (Print): __________________________________________________

Address: ______________________________________________________

City: ____________________________ State: ________________________


Witness:
Country: ___________________________ Zip/Postal Code: _____________

Phone: ________________________ Email: __________________________ Name (Print): _________________________________________________

Date of Shoot: ________________________ Medium: Still Video Signature: ___________________________________________________

Signature: _____________________________________________________ Date: ______________________________________________________

Rev. 1/201 4

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