DAMON HART-DAVIS
16 WILLINGHAM WAY, KINGSTON-UPON-THAMES, KT1 3JA
PHONE/FAX +44 020 8296 5577/8

Model Release

I hereby give Damon Hart-Davis the right to publish in any media the pictures he took of me on:

.....................(date)
and give up all claims in them.



Name of model (print) ................................................

Signed ...............................................................

Address ..............................................................

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Date .................................................................


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