Digital Model Release & Likeness Authorization

1. Model / Subject Information

Full Legal Name *

Email Address *

Mobile Phone

Shoot Category *

Session Date *

Shoot Location

Subject is under 18 years of age (Parent / Guardian Signature Required)

2. Statutory Likeness Authorization & Copyright Grant

1. Parties & Consideration

For valuable consideration received—including the professional creative production, photographic capture, and digital image delivery provided by Simba Photography LLC (NYS DOS ID: 6875002)—the undersigned ("Model/Subject") authorizes Simba Photography LLC and its legal representatives to record, capture, and reproduce their photographic likeness.

2. Scope of Grant & Portfolio Reproduction

Pursuant to New York Civil Rights Law §§ 50–51, Model irrevocably grants Simba Photography LLC the unrestricted, perpetual, worldwide right to use, publish, exhibit, and display photographs taken during this session in its professional artist portfolio, official website (simba.photography), verified social media accounts (@simbaphotography.us), studio marketing collateral, awards, and fine art exhibitions.

3. Copyright Ownership

Under Title 17 of the United States Code (Copyright Act), all original digital raw files, camera negative sensor data, and creative compositions remain the sole artistic property of Simba Photography LLC. Client/Model is granted a perpetual personal reproduction license to print, share, and enjoy retouched deliverables.

4. Defamation & Integrity Protection

Simba Photography LLC warrants that photographs will not be used in an obscene, defamatory, or unlawful manner.

3. Legal Digital Signature (ESIGN & NYS ERSA)

Sign above using finger, stylus, or cursor

Touch-enabled HTML5 canvas

I certify that I am at least 18 years of age (or legal guardian of the minor named above), authorized to sign, and intend this electronic signature to be legally binding under the federal ESIGN Act (15 U.S.C. § 7001) and the New York Electronic Signatures and Records Act (ERSA).

Release Certified & Filed

Your digital model release has been cryptographically recorded into the Simba Photography LLC legal vault.

REL-2026-0000

SIMBA PHOTOGRAPHY LLC
NYS DOS ID: 6875002 • Rochester, NY

REL-2026-0000
Sept 24, 2026

Model / Subject:	Jane Doe
Email / Phone:	jane@example.com
Shoot Category:	Portrait & Headshots
Location & Date:	Rochester, NY • 2026-09-24
Parent / Guardian:	N/A

Captured E-Signature (ERSA Compliant):