FEATURING YOU

Thank you for wanting to be featured on our website. We'd LOVE to feature you and hear about your journey, your goals, your inspiration. Please complete this questionnaire and model release to use your information.

In consideration of the engagement as a model of the minor or adult named below, and for other good and valuable consideration that I acknowledge as having received, , I hereby grant the following rights and permissions to Urban Soccer, LLC  ("Urban Soccer Store"), her heirs, legal representatives, and assigns, those for whom Urban Soccer Store is acting, and those acting with her authority and permission of myself or my minor child. They have the irrevocable, perpetual and unrestricted right and permission to take, use, re-use, publish, and republish photographic portraits, videos, graphics, quotes, interviews or pictures of me or in which I may be included, in whole or in part, or composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium at her studios or elsewhere, and in any and all media now or hereafter known, specifically including but not limited to print media and distribution over the internet for illustration, promotion, art, editorial, advertising, trade, or any other purpose whatsoever. I specifically consent to the digital compositing or distortion of the portraits or pictures, including without restriction any changes or alterations as to color, size, shape, perspective, context, foreground or background. I also consent to the use of any published matter in conjunction with such photographs or video. I hereby waive any right that I may have to inspect or approve the finished product or products and the advertising copy or other matter that may be used in connection with them or the use to which they may be applied.  I hereby release, discharge, and agree to hold harmless Urban Soccer Store, her heirs, legal representatives, and assigns, and all persons acting under her permission or authority or those for whom she is acting, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of such photographs, or video, or in any subsequent processing of them, as well as any publication of them, including without limitation any claims for libel or violation of any right of publicity or privacy.

I hereby warrant that I am of full age and have the right to contract in my own name. I have read the above authorization, release, and agreement, prior to its execution, and I am fully familiar with the contents of this document. This document shall be binding upon me and my heirs, legal representatives, and assigns.