MAGAZINE
www.NMCliQ.com
PHOTO RELEASE FORM
I, _____________________________________________ , grant to Dave Stabley, d.b.a. NM CliQ Magazine
(copyright owner)
permission to use the photos ________________________________ submitted, in any of its publications,
(submitters name)
including their website and Internet postings and any other lawful purposes to exclude porn and any other
illegal activities. I verify by signing this form that I have the right to publish the people in the photos and I own
the rights to have these photos distributed, published, or otherwise promoted by NM CliQ Magazine as they
see fit for their publication.
I hereby waive any right to inspect or approve the aforementioned use of the photographs now or in the future.
I understand that at no time will I be paid, reimbursed, compensated, or given royalties now or at any point in
the future by NM CliQ Magazine. I hereby authorize NM CliQ Magazine to copy, exhibit, publish, or distribute
these photos for purposes of publicizing or promoting NM CliQ Magazine in their publication or other media
for lawful purposes.
I hereby agree to release and hold harmless Dave Stabley, d.b.a. NM CliQ Magazine from any claims,
damages or liability arising from or related to the use of the photographs via electronic or print media, including
but not limited to any distortion, blurring, alteration, optical illusion or use in composite form, either intentionally
or otherwise, that may occur or be produced in production of the finished product. Note that the only editing
NM CliQ Magazine will do is to crop and scale the photos to fit a layout.
MODEL (Unless accompanied by valid Model Release)
By signing below I (model) affirm that I am at least 18 years of age and I am competent to contract
in my own name. Note that for implied or nude submissions, a copy of a photo I.D. (driver’s license)
may be required as a secondary confirmation of age.
Model’s Name: _________________________ Signature_________________________ Date: __________
I have read this release before signing below, and I fully understand the contents, meaning and impact of this
release. I understand that I am free to address any specific questions regarding this release by submitting
those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and
knowledgeable acceptance of the terms of this release.
Owner’s Signature: ______________________________________________ Date: _________________
Name: __________________________________ Photography Studio: _____________________________
Street Address: _________________________________________________________________________
City, State Zip: __________________________________________________________________________
Phone: ________________________ Email: _________________________________________________
Witness’ Signature: ______________________________________________ Date: _________________
After signing, please return to NM CliQ Magazine via e-mail at [email protected]