Model Release

I do hereby give Something Like Life Photography & Design, his or her assigns, licensees, successors in interest, legal representatives, photographic representatives and heirs the irrevocable right to use my name (or any fictional name), picture, portrait, or photograph in all forms and in all media and in all manners, without any restriction as to changes or alterations (including but not limited to composite or distorted representations or derivative works made in any medium) for advertising, trade promotion, exhibition, or any other lawful purposes, and I waive any right to inspect or approve the photograph(s) or finished version(s) incorporating the photograph(s), including written copy that may be created and appear in connection therewith. *
I have given Something Like Life Photography & Design permission to use the image I provided: To create a composite using my image in their Emu Digital Background. *
Please check one of the following boxes *
Model's Electronic Signature (or Parent/Guardian of Minor)
Model's Electronic Signature (or Parent/Guardian of Minor)
Date *