CAPT'N TOM'S ARTWORKS

MODEL RELEASE FORM

Mail With Photos To:

CAPT'N TOM'S ARTWORKS

111 NORTH STUART STREET

BALTIMORE, MARYLAND 21221 USA

It is fully understood and agreed by the MODEL, who is subject of the photographs submitted, and the PHOTOGRAPHER that:

1. The photographs are to be entered into Capt'n Tom's Website "SEXY FISHING PICTURES" section.

2. Permission is granted to Capt'n Tom's Artworks to publish any provided photograph/s on the Capt'n Tom's Artworks Internet Web Site as well as any other printed or published works including a calendar.

3. Capt'n Tom's Artworks has no obligation to model or photographer to publish or print any photographic entry.

4. Capt'n Tom's Artworks may decide to award winning contestants, BOTH MODEL AND PHOTOGRAPHER, at a later date.

5. MODEL certifies that she is at least EIGHTEEN years of age.

6. Sexually explicit photographic entries are NOT REQUESTED BY CAPT'N TOM'S ARTWORKS!

7. Notification and/or awarding of prizes if any, by Capt'n Tom's Artworks, will be sent to photographer and model at the addresses provided below.

8. For photograph authenticity verification purposes both model and photographer also provide phone numbers.

9. No photographs will be entered into competition without this fully completed, signed and verified MODEL RELEASE FORM.

10. Both model and photographer hold Capt'n Tom's Artworks harmless from any damages that may be incurred as a result of publishing or printing said photographic entry or entries.

By signing below, the parties acknowledge they have read, fully understand and agree to all of the terms and conditions above.

----------PHOTOGRAPHER:----------------------------------MODEL:----------

Name: ___________________________________ Name: ___________________________________

Street: ___________________________________ Street: ____________________________________

City, St., Zip: ______________________________ City, St., Zip: _____________________________

Phone: ____________________________________ Phone: ___________________________________

E-Mail: _________________________________ E-Mail: ______________________________________

Signature: _______________________________ Signature: _________________________________

ON A SEPARATE SHEET OF PAPER, PLEASE PROVIDE A FEW DETAILS ABOUT YOURSELVES.