Wisconsin Model Release Form 3
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Jeff Stelk

1782 Evergreen Ct • Custer, WI • 54423
[email protected] • jeffstelk.com • 715.630.8205

Model Release Form
Model/Client Details
Full Name: _______________________________________________________________
Address:

_______________________________________________________________

City: ________________ State: _________________ Zip: _________________________
Home Phone: _________________________ Cell Phone: __________________________
Email:

_______________________________________________________________

Shoot Location:

_________________________________________________________

Date:

_________________________________________________________

I understand that the photographs taken of me during this session can be used wholly or in part
in magazines, books, calendars, portfolios, exhibition and for internet, editorial, advertising or
educational use.
The photographs may be used to represent an imaginary person and any wording associated will
not be attributed to m