Image Copyright Permission and Licensing
Agreement.
Instructions: Copy and Paste into your Email then email it to
any other Party who claims interest in the Image.
(If you are the Model and have
a Release Form from the Photographer put N/A on Photographers part. If you
are the Photographer and have a Release Form from the Model put N/A on the
Models part).
Each Party can copy and Paste this form into email and save to
your computer then print.
After it is printed out, each fill in the form neatly and fax
it to 206 - 888 - 4642 or mail with the high resolution version of the Image.
Image Copyright Permission and License Royalty Agreement
This Agreement is between
Model on a Bottle ä
and the parties whom own this Image. (Copy and paste a small low resolution
version of the image in the space provided). For Identification purposes only.
The actual image must be high resolution raw image or retouched with copyright
stamps removed to reflect new copyright permission with a minimum of 600 dpi
sent by mail on CD to Model on a Bottle™
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Model Copyright Permission
I am the Model/Person in the picture (image) above and hear by give
permission to Model on a Bottle ä to locate for me
an Advertiser whom wishes to advertise next to my featured image.
In consideration of my engagement as a model, upon the terms herewith stated,
I hereby give to Model on a Bottle ä his/her
heirs, legal representatives and assigns, those for whom Model on a Bottle ä
is acting, and those acting with his/her authority and permission:
I hear by give Model on a Bottle ä the
unrestricted right and permission to copyright and use, re-use, publish, and
republish photographic portraits or pictures of me or in which I may be included
intact or in part, composite or distorted in character or form, without
restriction as to changes or transformations in conjunction with my own or a
fictitious name, or reproduction hereof in color or otherwise, made through any
and all media now or hereafter known for illustration, art, promotion,
advertising, trade, or any other purpose whatsoever.
b) I also permit the use of any printed material in connection therewith.
c) I hereby relinquish any right that I may have to examine or approve the
completed product or products or the advertising copy or printed matter that may
be used in conjunction therewith or the use to which it may be applied.
d) I hereby release, discharge and agree to save harmless [photographer],
his/her heirs, legal representatives or assigns, and all persons functioning
under his/her permission or authority, or those for whom he/she is functioning,
from any liability by virtue of any blurring, distortion, alteration, optical
illusion, or use in composite form whether intentional or otherwise, that may
occur or be produced in the taking of said picture or in any subsequent
processing thereof, as well as any publication thereof, including without
limitation any claims for libel or invasion of privacy.
e) I hereby affirm that I am over the age of majority and have the right to
contract in my own name. I have read the above authorization, release and
agreement, prior to its execution; I fully understand the contents thereof. This
agreement shall be binding upon me and my heirs, legal representatives and
assigns.
Dated:
_____________________________________
Signed:_____________________________________ Print Name___________________
Address:____________________________________ Alias _______________________
City:_______________________________________ Email: ______________________
State/Zip:____________________________________ DL # _______________________
Phone:______________________________________
Witness:_____________________________________
Photographer Copyright Permission
I am the Photographer whom took the Photograph of the Model whom is in the
Image shown above on this form. I hear by give permission to
Model on a
Bottle ä to locate for me a Business Sponsor whom will
sponsor the above Image on the Label of Model on a Bottle ä
.
In consideration of my engagement as a
photographer, upon the terms herewith stated,
I hereby give to Model on a Bottle ä his/her
heirs, legal representatives and assigns, those for whom Model on a Bottle ä
is acting, and those acting with his/her authority and permission:
I hear by give Model on a Bottle ä the
unrestricted right and permission to copyright and use, re-use, publish, and
republish photographic portraits or pictures of the above image or in which
Model may be included intact or in part, composite or distorted in character or
form, without restriction as to changes or transformations in conjunction with
my own or a fictitious name, or reproduction hereof in color or otherwise, made
through any and all media now or hereafter known for illustration, art,
promotion, advertising, trade, or any other purpose whatsoever.
b) I also permit the use of any printed material in connection therewith.
c) I hereby relinquish any right that I may have to examine or approve the
completed product or products or the advertising copy or printed matter that may
be used in conjunction therewith or the use to which it may be applied.
d) I hereby release, discharge and agree to save harmless Model on a
Bottle ä , his/her heirs, legal representatives or
assigns, and all persons functioning under his/her permission or authority, or
those for whom he/she is functioning, from any liability by virtue of any
blurring, distortion, alteration, optical illusion, or use in composite form
whether intentional or otherwise, that may occur or be produced in the taking of
said picture or in any subsequent processing thereof, as well as any publication
thereof, including without limitation any claims for libel or invasion of
privacy.
e) I hereby affirm that I am over the age of majority and have the right to
contract in my own name. I have read the above authorization, release and
agreement, prior to its execution; I fully understand the contents thereof. This
agreement shall be binding upon me and my heirs, legal representatives and
assigns.
Dated: _____________________________________
Signed:_____________________________________ Print Name___________________
Address:____________________________________ Alias _______________________
City:_______________________________________ Email: ______________________
State/Zip:____________________________________ DL # _______________________
Phone:______________________________________
Witness:_____________________________________
I the Model ________________________________and I the Photographer
______________________________ hear by state under penalty of Perjury that no
other person owns copyright, or has license or sublicense to the above image and
that we mutually agree to License this Image to Model on a Bottle ä
for the purpose of printing on labels our mutually owned Image which will be
sponsored by a Business whose Business Information will be listed on the Label
and be noted as Business Sponsor. We further agree to not license or sublicense
this image to any other similar business like Model on a Bottle ä
who would be considered competition and agree to not license this image to any
pornographic or other businesses that would be considered generally offensive.
This Business Sponsor may change on the label from time time and the Business
Sponsor will be screened for the same limitations.
Royalty Payment Compensation
Royalty Payment will be 3% of the wholesale price before shipping or taxes
listed on Model on a Bottle ä from which any person
may purchase the brand which features the mutually owned image. Every single
bottle or case sold that bears the mutually owned image shown in this agreement
and for which Model on a Bottle ä receives payment
from the purchaser will have 3% Royalty earmarked for payment to the Model and
or Photographer who mutually own the image and have signed this contract and whom
will receive payment as soon as the payment clears and paid to the Model and
Photographer on or about the first Friday of each Month and will be distributed
as follows.
_______% of the 3% Royalty will be paid to __ _______________________________
_______%of the 3%Royalty will be paid to the ________________________________
_______%of 100% of the cash Bonus or Prize will be paid
to__________________ (The cash bonus's will be listed on website AND
_______%of 100% of the cash Bonus or Prize will be paid to
_________________ (Applies to the ID no. on the bottle with this image only).
(Please confer with each other and discuss how much of the Royalty Payment
will be paid to the Model or Photographer and please note that this depends on
who owns the copyright and who will be managing the webpage ID on Model on a
Bottle ä and checking in with fans in the fan
club). Be fair.
It is the responsibility of the Receivers of the Royalty Payment Compensation
to always be in contact with Model on a Bottle ä
through the website at
http://www.ModelonaBottle.com
and to update address, phone and email changes so that payments can be made
without interruption. This agreement is good for 5 years and is cancelable
before that time in writing so long as Model and Photographer mutually agree to
cancel and or Licensee. After 5 years this agreement will be renewable if
all the parties agree and new agreement will be presented. All parties
understand that this Copyright permission and Licensing Agreement is not a
guarantee that the product will sell or that stores will purchase and that
Licensor (s) are not bound by exclusivity to only license this image with Model
on on a Bottle but agree that this image will not be licensed to other
competitive bottled water company's or any business involved with pornography,
hate crimes, violence, and other generally offensive issues.
Licensor know as Model hear by agrees to all the above terms.
____________________________________________Signature
Licensor known as Photographer hear by agrees to all the above terms
____________________________________________Signature
Licensee acting on behalf of __________________________Signature
Model on a Bottle ä
hear by agrees to all the above terms http://www.ModelonaBottle.com
10002 Aurora Ave. N. Suite 36/5548 Seattle, WA 98116 (206) - 309-0485
