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Model and Image Release Form

A completed fictional image release with specified media, territory, term, editing, moral-rights treatment, payment and UK GDPR limits.

Jurisdiction: England and Wales - completed fictional worked example

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Important: This sample provides general legal information only and is not legal advice. Check the law, prescribed forms and signing requirements that apply to your exact jurisdiction and circumstances before use.

# MODEL AND IMAGE RELEASE FORM

Date: 18 July 2029

Parties: Tessa Brown and Brightwater Homeware Ltd

## 1. Parties and capture

Tessa Brown of 6 Orchard Mews, Bristol BS5 8QT gives Brightwater Homeware Ltd (Company No. 13048562) consent to capture her photograph, likeness and recorded voice during the 18 July 2029 studio session for the “Quiet Kitchen” campaign. She confirms she is an adult with capacity to sign.

## 2. Rights granted

Tessa grants Brightwater a non-exclusive, worldwide licence to reproduce, edit, publish, communicate and distribute the approved photographs and short video clips in Brightwater’s website, social media, online advertising, catalogues and UK point-of-sale materials. The licence lasts three years from first publication.

## 3. Media, territory and term

Brightwater may crop, colour-correct, retouch and add text or product composites, but must not create a materially defamatory or misleading depiction. Tessa has no general pre-publication approval right; Brightwater will not use her image for political advertising, medical claims or adult content.

## 4. Editing and credit

The agreed fee is £650 inclusive of any VAT properly chargeable, payable by BACS within 14 days after the session. Tessa asserts her right to be identified as the performer where legally applicable but consents to omission of a credit where the campaign format does not allow one; the parties record any CDPA 1988 moral-rights waiver narrowly.

## 5. Consideration and data

Brightwater is controller of the image and contact data for campaign management and retains working files for the licence term plus three years for legal and accounting purposes. It applies access controls and gives Tessa the privacy information and UK GDPR rights notice; the release is not a blanket consent to unrelated processing.

## 6. Withdrawal and liability

Tessa may withdraw consent for future voluntary uses by written notice, but withdrawal does not require recall of lawful materials already printed or published and does not undo the contractual licence for the agreed term. Brightwater remains responsible for its own negligence and unlawful use; Tessa warrants no conflicting release exists.

## 7. Consent and signatures

English law governs and the courts of England and Wales have jurisdiction. Tessa and Brightwater’s authorised producer Maya Chen sign on 18 July 2029. No minor or guardian consent is involved; a new written release is required for a materially different campaign, product or use.

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