Application (please print clearly):

Name of Applicant:_____________________________________________________________

Phone Number: ___________________________(Home)__________________________(Cell)

Street Address:________________________________________________________________

City, State, Zipcode: __________________________________________________________

Date of Birth (MM/DD/YY) _____________________________________________________

Email address _________________________________________________________________

School (if applicable): ___________________________________________________________

MODEL RELEASE FORM AND APPLICATION:

In exchange for consideration received, I hereby give permission to The Exquisite Bride, L.L.C. and Mon Cheri, L.L.C. to use my name and photographic likeness in all forms and media for advertising, trade, and any other lawful purposes.

Print Name:                                  ___________________________________________  

Signature:                ____________________________________________                    

Date:              _____________                      

If Model is under 18:
I,                                     , am the parent/legal guardian of the individual named above, I have read this release and approve of its terms.

Print Name:               _____________________________________________                     

Signature:               ______________________________________________                     

Date: