Susan Shea Photography

281 Chauncey Walker Street, Lot 111, Belchertown, MA 01007


High School Senior Picture Contract



I, ____________________________________________________________(model name), for good and valuable consideration, the receipt of which is hereby acknowledged, hereby irrevocably authorize Susan Shea and Susan Shea Photography to use photographs of me and or my property and authorize her, licensees, legal representatives and transferees to use and publish (with or without my name, company name, or with a fictitious name) photographs, pictures, portraits or images herein described in any and all forms and media and in all manners including composite images or distorted representations, and the purposes of publicity, illustration, commercial art, advertising, publishing (including publishing in electronic form on CDs or internet websites), for any product or services, or other lawful uses as may be determined by the photographer or studio named here.

I further waive any and all rights to review or approve any uses of the images, any written copy or finished product. I am of full legal age and have read and fully understand the terms of this release.



MODEL (if 18 years of age) Signature________________________________________ 

Date ____________________________________________ Name_________________________________________

Address _________________________________________ City_______________________________ State _________ Zip _________________

Phone __________________________________________


LEGAL GUARDIAN (if under 18 years of age) Signature________________________________________Date________________________


Address _______________________________________ City_______________________________State____________ Zip______________


Signature______________________________________________________________ Date________________________________