"(Requis)" indicates required fields

Name of participant / extra(Requis)
Date of birth(Requis)
Date of photo / video project(Requis)
I hereby authorize MALAD Communication inc, (hereinafter referred to as “MALAD”), as well as all its clients, agents, representatives, employees and any third party acting on its behalf or on behalf of its clients (hereinafter referred to as “CLIENTS”), to use, reproduce, distribute, publicly display and create derivative works of my image, voice, and/or my performance (hereinafter referred to as “MEDIA”) captured at any time by MALAD and its CLIENTS, whether before or after the date of signing this form, in connection with any activities of MALAD or its CLIENTS, including but not limited to promotion, sales, advertising, trade, art and illustration.

I understand that this consent applies to all MEDIA taken or created by MALAD and its CLIENTS, past, present and future, without the need for renewal or additional consent for each future use or each new project.

I understand that MALAD and its CUSTOMERS have the right to use these MEDIA in an unlimited manner, without restriction of time, place or media, in any printed or electronic document, book, brochure, corporate document, promotional tool, magazine, newsletter, website, social networks and any other document of a similar nature.

I hereby release and discharge MALAD and its CUSTOMERS from any and all liability, claims, actions, demands, costs or expenses of any nature whatsoever which I may now or hereafter have by reason of the use and/or publication of the MEDIA.

I have read and understood this consent and release form before signing it, and I accept the terms and all their implications.

If I am the parent or legal guardian of a minor model, I declare that I have the legal authority to sign this consent form and release on his/her behalf and I give MALAD and its CLIENTS irrevocable permission to use the MEDIA as described above.