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MODEL RELEASE/MEDIA CONSENT FORM

I hereby irrevocably consent to the unrestricted publishing, photographing, videotaping or otherwise recording or broadcasting of my photographs, video, image or likeness by the boutique owner or designer booking a model at Moda Munchkin.com.

A model over the age of 18 does not need parental consent, but does need to agree to the model release/media consent form.

Full name of parent:
(model if over 18)

Full name of model:

Address:

Contact phone number:

E-mail:

Date:

I do not consent to the above:
(please type I Do Not Consent)

 

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All Rights Reserved.