Back WORLD GYM BURPENGARY - Adult Model Release DateDayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920First and Last Name*Photo taken of who, location and timePhoto Consent* I agree to the followingFull Legal Names: Burpengary Gym Pty Ltd – ABN – 18 614 531 467 Address: Shop 9 , 161 Station Road, Burpengary, QLD, 4505. Full Legal Names: Raw Power Meals Pty Ltd – ABN – 85 638 498 129 Address: Shop 9 , 161 Station Road, Burpengary, QLD, 4505. Telephone Number and Email Address: 07) 3053 3170 justin@worldgymburpengary.com.au (Hereinafter referred to as "the Client") Whereas for valuable consideration hereby acknowledged as received, the Model granted the Client permission to photograph and/or film and sound record the Model and furthermore grants permission to use the resulting work ("the Work") according to the terms stated hereunder: • Any permission granted to the Client shall extend to his/her successors, legal representatives, licensees and assigns and shall be irrevocable and perpetual without any further or additional claim for compensation by the Model. • Use of the Work shall be unrestricted as to location, quantity or frequency, may be for any purpose and in any medium whatsoever, whether foreseen or unforeseen at this time, except where such use is in contravention of the law. • Permission is specifically granted for the Work to be edited, altered, distorted, used in whole or in part, in conjunction with other images, graphics, text and sound in any way whatsoever and without restrictions. • Permission herein granted is absolute and final and shall not be subject to further inspection or approval by the Model at any stage in the use of the Work. • Use of the Work may be in conjunction with the Model's own or fictitious names. • The Client shall own all rights in the Work which shall accrue to the benefit of his/her successors, legal representatives and assigns. • Notwithstanding the above, the following uses are specifically noted and agreed to and specific exclusions for use listed here shall take precedence and restrict the use of the Work accordingly: • The model may use the material produced as provided to them by the client within their own portfolio for personal promotion only. Such license may be withdrawn by the client at any time should it deem the models use of the material as offensive or objectionable • The Model warrants having read and understood this Model Release Agreement and warrants being of full legal age to enter into an agreement. • With full knowledge of the above, the Model hereby releases and shall hold harmless the Client and his/her successors, legal representatives, licensees and assigns from all claims or damages including but not limited to defamation or violation of right of privacy or publicity, resulting from or associated with the use of the Work. • The Model agrees that the provisions contained herein shall be binding upon the Model and his/her successors, legal representatives and assigns. • This Agreement shall be construed, interpreted and governed in accordance with the laws of the State of Queensland Australia and should any provision of this Agreement be judged by an appropriate court as invalid, it shall not affect any of the remaining provisions whatsoever. • The parties agree that any or all parts of this agreement may be submitted to the other party in legible and recordable electronic form and upon acknowledgement of receipt by the receiving party shall become valid parts of the agreement. Sponsorship Agreement :- The parties both enter into a Sponsorship Agreement whereby both the model and the client agree to perform and provide certain goods & services for mutual benefit. Upon signing this agreement the client offers the model the opportunity to represent the client as a “brand ambassador” for both business’s covered under this agreement both World Gym Burpengary & Raw Power Meals. You may select the products and services that you may choose to promote and represent :- (Please Check) • World Gym Burpengary Supplements • World Gym Merchandise • World Gym Burpengary Facility • Global Fitness College – Fitness Courses • Raw Power Meals – Ready Made Meals Upon signing this agreement the Model will be expected to discuss, recommend and promote the Clients products where possible and appropriate. This agreement has been created in order to develop a mutually beneficial partnership between the client and the model. This agreement can be cancelled with 30 days notice by either party made in writing and submitted to the clients/models nominated email address.Phone*Email* Electronic Signature* I understand by SIGNING my name and pressing submit, that the information is true and correct.Signature