Strike a Pose Model Search Saturday, June 11, 2011

Strike a Pose Model Search – Saturday, June 11, 2011

8am-10am Registration 10am Catwalk for ages 5-12 11am Catwalk for ages 13-20 1:30pm Winners Announced

PARTICIPANTS MUST BE PRESENT TO WIN

Registration Form Return form to Citadel Outlets Customer Service

Model Name______

Age______Birth date______

Home Phone______Cell Phone______

Work Phone______Email______

Address______

City______State______Zip______

Height______Previous Modeling Experience: yes___ no___ | If yes: Agency______

Parent or Guardian’s Name______* Information provided above will be shared with sponsors. * Must be able to attend professional photo shoot on July 9, 2011 at 10am at Citadel Outlets.

How did you hear about the Strike a Pose Model Search? (Please check all that apply) Radio ____ Facebook____ Twitter____ Billboard____ Friend____ Sign/Flyer____ Web Site____ MySpace____ Blog____ Customer Service____ Other ______

Photo Release

For valuable consideration, I hereby confer on Citadel Outlets the absolute and irrevocable right and permission with respect to the photographs that he/she has taken of myself or if under 18, my minor child in which he/she may be included with others: a) To copyright the same in Citadel Outlets name or any other name that he/she may select; b) To use, re-use, publish and re-publish the same in whole or in part, separately or in conjunction with other photographs, in any medium now or hereafter known, and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion, advertising and trade, and; c) To use my name or my child’s name in connection therewith if he/she so decides. I hereby release and discharge Citadel Outlets from all and any claims and demands ensuing from or in connection with the use of the photographs, including any and all claims for libel and invasion of privacy. This authorization and release shall inure to the benefit of the legal representatives, licensees and assigns of photographer Citadel Outlets as well as the person(s) for whom he/she took the photographs. I have read the foregoing and fully understand the contents hereof. I represent that I am the [parent/guardian] of the above named model. For value received, I hereby consent to the foregoing on his/her behalf.

Date: ______Model Name:______

Parent or Guardian (if under 18):______

Address:______City:______State/Zip:______Phone:______Signature:______(Guardian Signature if Model is under 18 years of age)