MODEL/PARENT/GUARDIAN INFORMATION
Please tick the relevant box below:
I represent that I am the age of eighteen (18) years (or twenty one (21) in certain counties/states) or above and
that I have read the foregoing and fully and completely understand the contents hereof.
or
I represent that the model is a minor and that I am the parent / duly authorized representative of the model and
that I have read the foregoing and fully and completely understand the contents hereof.
Model’s or Parent's Signature : ________________________________________________________
Model's Permanent Address : ________________________________________________________
________________________________________________________
WITNESS INFORMATION
Name (Print) : ________________________________________________________
Signature : ___________________