MODEL RELEASE FORM Name * First Name Last Name Phone (###) ### #### Email * Checkbox Check the follow boxes I consent and authorize By Adriane Nicole to use my likeness in any photograph, video, or other digital media (photo/video) in any and all of its publications, including print or web-based publications. I irrevocably authorize By Adriane Nicole to copy, edit, enhance, crop, or otherwise alter any Photo/Video for use in their publications. I also waive any rights for approval or inspection of any Photo/Video. I understand and agree that all Photo/Video are property of By Adriane Nicole, and will not be returned to me. I acknowledge that I am not entitled to any compensation or royalties with respect to the use of the Photo/Video I agree to release and forever discharge By Adriane Nicole and its affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them, in their individual and/or corporate capacities from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, known or unknown, which I, and anyone claiming on behalf of me, may have or claim to have against Releasee in connection with this Release. I have carefully read and fully understand all the provisions of this Photo Release Form and am freely, knowingly and voluntarily signing. Signature By typing your name below you agree to digitally sign this contract Thank you for signing the model release form!