To the Photographer: Samantha Dawn

Address: 106 Baker Avenue, Arnold, Nottingham, NG5 8FU

Phone: 07465983323

Location: 106 Baker Avenue, Arnold, Nottingham, NG5 8FU

I, the model, grant you, the photographer, usage of the photographs subject to the following conditions:

Photographer Signature:

(both parties to sign here to agree these special conditions)

I acknowledge that by signing this form, subject to the usage restrictions above, I give up all claim of ownership of the photographs, and assign copyright to the photographer named above. No further payment will be due. Use of the photographs may be granted to third parties: however the photographys will remain the property of the photographer.

I have read this form carefully and fully understand the implications. I am 18 years old or over.

If the model is under 18 years of age, a parent or legal guardian must sign.