Hold
Harmless and Indemnity Agreement
To Whom it may
Concern:
I hereby authorize the
release of any and all images of me encompassing the time period
from the date of this Agreement forward. Also, I hold Photos
by Corwin harmless and indemnify him for such usage.
I specifically give permission
to Photos by Corwin to use, sell or display my image in
any media he chooses. In that regard, I hereby give the copyright
of this image to Photos by Corwin.
I understand that the
photographs of myself may be displayed in Corwin’s home, in
galleries, on any Corwin website, in movies or in any other non-paying
venues and that no money will be owed to me.
I further understand
that I will be credited as the model should I so request it or kept
anonymous should I so request it.
Should any photograph
of myself be sold, I will be compensated with 25% of the monies
received, less any matting, framing costs or postage/freight costs.
Should the photo be of
me and include other people, I understand that this percentage will
be split between myself and the other model(s).
A copy of this authorization
has the same force and effect as an original.
Signed: ______________________________
Date: _______________DOB: ______________
Printed name: _______________________________________
SSN: ____________________
Mailing address for checks:
______________________________________________________
____________________________________________________________________________
Email address: ________________________________________________________________
Restrictions?
Please initial below:
No restrictions:
_____ It’s OK for
people to know I’m the model
Restrictions:
_____ I do not want anybody
to know these images are of me
(Note: earnings will
only be reported to IRS if annual compensation exceeds $600.00)
Witness: __________________________________ Date:_______________________
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