Tennessee Model Release Form 2
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Model Release
I, _______________________________, do hereby give East Tennessee State University, its
assigns, licensees, and legal representatives the irrevocable right to use my name, picture,
portrait, or photograph in all forms of media and all manners, including composite
representation, for advertising, trade, or any other lawful purposes, and I waive any right to
inspect or approve the finished product, including written copy, that may be created in
connection therewith. I have read this release and am fully familiar with its contents.

SIGNED_______________________________ WITNESS_____________________________
ADDRESS_____________________________ ADDRESS_____________________________
______________________________________ _____________________________________
DATE_________________________________ DATE________________________________

I am the parent and guardian of the minor named above and have the legal authority to execute
the above rele