Tennessee Model Release Form 3
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Randall House Model Photo Release Form
PO Box 17306, Nashville, TN 37217
800-877-7030 / [email protected]

By signing this release I give Randall House Publications and the National Youth Conference my
permission to use the image(s) in any manner which may include, among others: advertising, promotion,
publication, and online publication. I agree that the image(s) may be combined with other images, text
and graphics, and cropped, altered, or modified. I agree that I have no artistic rights to the image(s), and
all rights to the image(s) belong to Randall House Publications.
Please check one:

__ I am at least 18 years of age and have the full legal capacity to execute this release.
__ I am the parent with full rights to sign this form on behalf of my child (who is under 18 years of age).
Model means me and includes my appearance, likeness and form.
Images refers to all photographs, videos, artistic rendering, or recording of me.
Parent means the parent and/or legal guardian of the M