LAURITA WINERY/DANCER FARM B&B MODEL RELEASE
I hereby give permission to Laurita Winery/Dancer Farm B&B to use my name and photographic likeness in all forms and media for advertising, trade and any other lawful purposes.
Print Name:
Signature:
Date:
If Model is under 18:
I, the parent/legal guardian of the individual named above, have read this release and approve of its terms.
Print Name:
Signature:
Date:
Information from Photographer::
Title of photo:
Name of photographer:
Comments on photo:
Photo Registration Number(s):
Please mail or deliver in person the hand signed hard copy of the release to: Laurita Winery 35 Archertown Road New Egypt, NJ 08533