For valuable consideration received, the receipt and sufficiency of which are hereby acknowledged, I __________________________________________________________ (name of talent/model) hereby forever grant to __________________________________ (name of photographer or company), his/her/its legal representatives, successors, assigns, licensees, advertising agencies, and all persons or corporations acting with his/her/its permission, the irrevocable and unrestricted right to use, re-use, publish and re-publish, and copyright my performance, likeness, picture, portrait, photograph, sound and/or voice recording, including the negatives, transparencies, prints, film, video, tapes, digital or other information pertaining to them in all forms of media now or hereafter known and in all manner, including electronic media, in still, single, multiple, moving or video format, in whole or part and/or composite representations, in conjunction with my own or a fictitious name, including alterations, modifications, derivations and composites thereof, throughout the world and universe for advertising, promotion, trade, or any lawful purposes.
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