Birth Professional - Model Release Form
Birth Photographer: ________________________________________________________
Birth Client/Model: ________________________________________________________
Birth Client Email Address: __________________________________________________
I, the birth client/model, _________________________ , grant the photographer (Allison Blake with Allison Blake Photography) the perpetual, irrevocable, and unrestricted right to use and
publish all video and/or all photographs taken during my labor, birth, and postpartum period.
I agree not to prosecute or to institute proceedings, claims or demands against the photographer in respect to using any of the above mentioned photographs. I release the photographer
from all claims and liability relating to video or photographs taken of me.
I agree that the photographs created by (Allison Blake with Allison Blake Photography) are the exclusive property and copyright of the photographer, and that I will retain no commercial rights or copyright to the images.
I, the birth client/model, ______________________ is hereby granted permission by Allison Blake of Allison Blake Photography (ABP) to reproduce the images and make an unlimited
number of prints, for personal use only. _______________________ agrees that they may not use any ABP images for commercial or editorial purposes, or enter any ABP images into
competitions or contests of any kind, without the express written permission of ABP. _______________________ also agrees that they are not allowed to give permission for any
entity, company, social media site, blogger, news outlet, etc to use these photos in any way. I own copyright of these files and any request to use these files must be
directed to me and will be up to my sole discretion to accept or deny. Any attempt to allow the aforementioned entities access or use of these files may result in lawful action.
Allison Blake with Allison Blake Photography retains the copyright to all images, per USC Title 17 (US Copyright Law).
The images that are being provided to you, are licensed to you for any reasonable personal use, including but not limited to: printing, copying, emailing, and web publishing.
Your license does not include use that results in financial gain, including but not limited to: advertising, stock photography, print sale profits, contests, publications, or resale of any nature.
You may not alter any of the images in any way. This includes but is not limited to: cropping, changing the size, adding filters, or any other additional types of editing.
You must not change any file in any way. ABP may revoke this license at any time and for any reason.
Any attempt to claim the photos as client’s own will result in lawful action. Any attempt to reproduce photos which you do not have a printing rights agreement for,
will result in a breach of contract.
I have read this model release form carefully and fully understand its meanings and implications.
Birth Client's / Model’s signature _______________________________ date __________
Photographer’s signature _______________________________ date __________
Witness signature _______________________________ date ___________