September 23rd and 24th
Indicates required field
Date of Photoshoot
please include 4 character year i.e. 01/15/2020
Location of photoshoot
Studio (winter street)
Other Agreed upon location
if location other then studio
Year Month Day
Headshot (image of your face)
Max file size: 20MB
Use your camera on your phone if UNDER 18 include image with guardian
If you are
please include your
Guardian in your photo
and have them check the box that they are aware that you are modeling and the purpose of the images.
I am aware and give permission to the minor in my care to participate as a model. I have reviewed this form and agree to terms and conditions
Terms & Conditions
I understand that these images are going to be used for marketing purposes and have no rights to the images.
I will not hold Jackson/Jack Potts, Bohemian Photography, Crysta Gebert or Aura Brushed responsible for the use of these image in promotional and marketing.
Please mark your level of comfort
Fine Art Nude/Implied
Nude (18 + only)
Check all that apply
Open Communication policy in our working environment. You as the model have control on what you are comfortable with, if at any point you do not feel comfortable with the direction you are given you are encouraged to let us know. We recommend the phrase “could we try something else” this will let us know in a subtle way. We will be able to redirect the shoot to avoid any fear or frustration.
Submit Model Release
studio 2101 Winter St #C7, Houston, TX 77007
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2101 Winter St #C7, Houston, TX 77007