Agreement *

I hereby grant Tony Newby Photography and any licensees or assignees, the absolute right to use my name and portrait/photographs and any other reproductions or adaptation from the below mentioned photographic shoot,in all forms and media and in all manners, for advertising, trade or any other lawful purposes. I waive any right to approve the finished version. I understand that the Photographer owns the copyright of their work and I therefore waive any claims I may have based on any use of the photographs. I am over 18 years of age. A parent or guardian must sign for anybody under 18.

I agree to these conditions.

I agree to these conditions based upon the restrictions detailed below

Name *

First Name

Last Name

Date of Shoot *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country