Date: ______________

              ModelStats.com Minor Release Form

In consideration of the promotion as a model of the minor named
below and upon the terms herein stated, as his/her legal
representative(s) and assigns, I/we hereby grant ModelStats.com
authority and permission to use photographic images on and only
on the internet domain ModelStats.com for said promotion of the
minor or in which the minor is included without restriction as
to minor changes or minor alterations from time to time; in
conjunction with the minor's own first name only and a model
reference number and the statistics that are submitted on the
application by  the model and/or parents/guardians.

[(In plain English) The above paragraph gives ModelStats.com
the release of images of the youth to be represented for use on
and only on ModelStats.com web site. It does allow us to make
minor changes to a photograph, like cropping and size. It states
the photos will only be included with the specific information
provided by the model's parents or guardians.]

I hereby release, discharge and agree to save harmless 
ModelStats.com, their legal representatives or assigns, and all
persons acting under their permission or authority or those for
whom they are 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 by other persons or entities not related to
ModelStats.com in the taking (stealing) of said picture or in any
subsequent processing thereof, as well as any publication thereof
even though it may subject the minor to ridicule, scandal,
reproach, scorn and indignity.

[(In plain English)
The above paragraph says you won't hold the domain ModelStats.com
responsible for the unethical actions of others.]

I hereby warrant that I am of full age and have every right to
contract for the minor in the above regard. I state further that
I have read the above authorization, release and agreement, prior
to its execution, and that I am fully familiar with the contents
thereof.

[(In plain English) This states you are signing this release and
that you understand it.]

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              ModelStats.com Minor Release Form
			(signature page)


Dated: ________________________

(Please Print) Minor's Name:____________________________

Minor's Address: _______________________________________

(Father, Mother or Guardian): __________________________

Address: _______________________________________________

(Father, Mother or Guardian): __________________________

Address: _______________________________________________

Witness: _______________________________________________


Submit to: 

Ken Greening
ModelStats.com
8006 Cliff Drive
Merriam Woods, MO 65740
















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