Model Release Form

Virginia Tourism would love to use your images in our marketing efforts! Please have the model(s) complete the release form below, including a description of the photographs/video being shared, their location(s), and the date.

If you have any questions, please reach out to Sarah Ann Atkins at [email protected]

Consent(Required)

For good and valuable consideration received, the sufficiency of which is herein acknowledged , and by signing this release, I hereby authorize Virginia Tourism Authority, d/b/a Virginia Tourism Corporation (VTC) a public body corporate and political subdivision of the Commonwealth of Virginia, its legal representatives, and its successors and/or assigns, to use my photograph(s) and/or video image(s) (the "Content") in perpetuity to advertise, publicize and/or promote Virginia without further consent by myself or other persons, and for no further right to additional consideration or accounting. Permission is also granted for the use of my image on a non-exclusive basis throughout the world on all forms of media and the internet by VTC, its legal representatives, and its successors and/or assigns, VTC identified industry partners, and affiliated Commonwealth of Virginia agencies and political subdivisions, or any other entity VTC deems appropriate. I hereby waive any right to the Content and further waive any right that I may have to inspect or approve the finished product(s) and the advertising, publicity or promotional copy that may be used in connection therewith or the use of which it may be applied. I hereby warrant that I am of the age of majority and have the full legal capacity and right to contract in my own name. I have read the above authorization, release, and agreement, prior to its execution, and I am fully familiar with the contents thereof. This
release shall be binding upon me and my heirs, legal representatives, successors and/or assigns. I agree that this release is irrevocable, worldwide, and perpetual, and will be governed by the laws of the Commonwealth of Virginia.

I agree

Model Release Form(Required)

Describe the Photograph(s) and/or Video(s) including the location and date:

Model Name

First Last

Is the model aged 18 or older?(Required)

Yes

Parent/Guardian Permission(Required)

I, the parent or legal guardian of the model, have read the above authorization, release and agreement and I am fully familiar with the contents thereof. I give my consent and agree to the uses as stated above.

I agree.

Guardian Name(Required)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Headshot(Required)

Accepted file types: jpg, jpeg, png, Max. file size: 100 MB.

Please upload an image of model

Consent(Required)

If model is underage (under 18):
I, the parent or legal guardian of the model, have read the above authorization,
release and agreement and I am fully familiar with the contents thereof. I give
my consent and agree to the uses as stated above.

I agree to the privacy policy.

Electronic Signature(Required)

Please type your signature in the box below.

Untitled

First Choice

Second Choice

Third Choice