Fields marked with an * are required * I understand that all information I provide will be printed exactly as I submit it; including capitalization and my bio. I understand that I am responsible for spell checking and grammer. Legal Name * Pin Up Name * Bio * What is a Modern Day Pin Up to you? * Are you listed on www.PinUpDatabase.com ? * Yes No Email * Photo Credit * Photographer Email * Makeup & Hair Credit Makeup & Hair Social Media Link Photographers Social Media Link * Your Pin Up Social Media Link * Website File Upload * Select Files Cancel File Upload Copy Select Files Cancel File Upload Copy Copy Select Files Cancel File Upload Copy Copy Select Files Cancel File Upload Copy Select Files Cancel File Upload Copy Copy Select Files Cancel Photo Release * In consideration as a content provider and for good and valuable consideration herein acknowledged as received, I grant Modern Day Pin Up Magazine and its legal representatives and assigns, those for whom Modern Day Pin Up Magazine is acting, and those acting with Modern Day Pin Up Magazine’s authorization, the license to use in her/his name or otherwise, and re-use, publish, re-publish the submitted photographs and content pertaining to me or in which I may be included in conjunction with my own or a fictitious name, or reproduction thereof in color or black and white, or otherwise made through any and all media now or hereafter known, for illustration, promotion, art, or any other use related to Modern Day Pin Up Magazine. I also consent to the use of any text used in conjunction with my submission. I understand there is no commission or compensation for provided materials, this being print copies or digital copies - however promotional graphics and tear sheets are available. By signing this agreement, you understand that print or digital copies are not provided. I hereby agree to release, discharge and agree to save harmless Modern Day Pin Up Magazine, legal representatives and all persons acting under its authority, from any liability in any way, that may occur or be produced in the taking of said photos or in any subsequent rendering, including without limitation any claims for libel or invasion of privacy. Clicking this agreement does not guarantee inclusion in any specific issue and may be retracted by the publisher at any time for any reason whatsoever. I hereby warrant that I am of legal age (to be in photographs) in the jurisdiction in which this release is executed and have the right to contract in my own name, that I have read this agreement and fully understand and agree to the terms. This release shall be binding upon me, my heirs, my legal representatives. I confirm that any forms of identification or other documents I have shown the photographer to establish my age are legal and valid. This release grants Modern Day Pin Up Magazine permission to publish and republish photos, articles and content without time limit or restricted to any medium currently available or available at a future time. Photos will be used based on timing, deadlines and available space. Please notify verbally or in writing all involved parties of the submitted materials that you have submitted it for publication. Please do not submit content that has already been published, we seek unpublished work only – If your work is widely shared on social media prior to publishing it may be pulled from consideration. By Clicking the box provided you are indicate acceptance of terms with the checkbox. Modern Day Pin Up Magazine reserves the right to use any photos submitted for any reason including and not limited to print, web, video and television broadcast. By Clicking this box, I agree that I own these photos and the photographer has allowed publication of these images Message * If you are a human seeing this field, please leave it empty.
