Permission for Photography    
(Toestemmingsverklaring van fotomodellen)
*copy the following text, fill out, sign and mail to foto-rik@live.nl
MODEL RELEASE AND CONSENT AGREEMENT
1.
For valuable consideration, the adequacy of which
is acknowledged, for your
photographing me, and knowing that you have and wil
l expend substantial expenses and time
in reliance upon this Release and Consent, I
irrevocably and absolutely consent to the
unrestricted use by __Rik Besselink photography__
and his heirs, successors, assigns, and
designees (“Photographer”), and those acting with 
Photographer’s permission and authority, of
my name and any and all photographic or other images
(“Images”) of me that Photographer
creates or makes, for all purposes, in any form, in
conjunction with my own or a fictitious name,
and in any and all media, including, without
limitation, advertising, art, promotion, solicitation,
or trade.
2.
I waive any right to inspect or approve the finished
Images, advertising copy, text, or
other printed matter that may be used in
conjunction therewith, or to the eventual use that the
Images may be applied.
3.
I release and discharge Photographer and those
acting under Photographer’s authority
from any and all liabilities, claims and demands
arising out of or relating to any blurring,
distortion, use in composite form, or alteration
whether intentional or otherwise, that may
occur or be produced in connection with the Images,
or in connection with any processing,
alteration, transmission, display, publication or o
ther use of the Images.
4.
I hereby forever release and discharge Photographer,
his heirs, legal representatives,
agents, assigns and the party for whom the photographs
were made, from any and all claims,
actions and demands arising out of or in connection
with the use of said Images, including
without limitation, any and all claims for invasion
of privacy and libel.
5.
This Agreement constitutes the sole, complete and
exclusive agreement between
Photographer and me regarding the Images and I am
not relying on any other representation
whether oral or written.
6.
I hereby affirm that I am over the age of majority
and have the right to contract in my
own name. I have read the above authorization,
release and agreement, prior to its execution;
I fully understand the contents thereof. This
agreement shall be binding upon me and my heirs,
legal representatives and assigns.
SIGNATURE/DATE_______________
TELEPHONE #__________________
NAME_________________________
ADDRESS______________________
IF MODEL IS A MINOR, PARENT OR GUARDIAN MUST SIGN B
ELOW
:
I, the undersigned, being parent or guardian of the
minor whose name appears above, hereby
consent to the foregoing conditions and warrant tha
t I have the authority to give such consent.
SIGNATURE/DATE    _______________
TELEPHONE #    __________________
NAME OF PARENT/GUARDIAN______________
ADDRESS    ______________________

Rik Besselink