Your Contact Information:

First Name:

Last Name: Phone Number: Address:

City:

Country:

State:

Zip:

Email Address:

Nearest major city to you?



Your Experience:

Website 1 (use http://):

Website 2 (use http://):

How did you find us?

Other Comments?

Upload your images * For Internal Use Only Files must be under 3MB and in JPEG (*.jpg, *.jpeg) format.



Electronic Waiver

Agreement 1: ROCK GOD LLC Model Agreement V.1 2010


In consideration for value received, I do hereby authorize ROCK GOD LLC (Photographer/Videographer) his or her assigns, licensees, successors in interest, legal representatives, and heirs the irrevocable right to use my name (or any fictional name), picture, portrait, or photograph in all forms and in all media and in all manners, without any restriction as to changes or alterations (including but not limited to composite or distorted representations or derivative works made in any medium) for advertising, trade, promotion, exhibition, or any other lawful purposes, and I waive any right to inspect or approve the photograph(s) or finished version(s) incorporating the photograph(s), including written copy that may be created and appear in connection therewith. I hereby release and agree to hold harmless the Photographer/Videographer, his or her assigns, licensees, successors in interest, legal representatives and heirs 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 the photographs/video, or in any processing tending toward the completion of the finished product, unless it can be shown that they and the publication thereof were maliciously caused, produced, and published solely for the purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn, and indignity. I agree that the Photographer/Videographer owns the copyright in these photographs/video and I hereby waive any claims I may have based on any usage of the photographs/video or works derived there from in perpetuity, including but not limited to claims for either invasion of privacy or libel. I agree that this release shall be binding on me, my legal representatives, heirs, and assigns. I have read this release and am fully familiar with its contents. I acknowledge that the photographic/video session was conducted in a proper and professional manner and that this release was willingly signed after the session was completed. I certify that I am more than 18 (Eighteen) years of age, and am free and able to give such consent. *Any questions regarding this waiver can be directed to brandvisionaries@gmail.com I am 18 years of age or older. You must be 18 or older to apply as a model

Check to agree to our terms of service.

Please type your full name to digitally sign this agreement:

Please enter in the word you see below:

trend bungalow brands

$49 eyewear that looks and feels like $200 eyewear. Free shipping. Free returns. You can't go wrong. Get the hottest runway looks and couture quality for less. We'll be adding apparel, accessories, and beauty products soon!

celebrity love

Celebrities love our fashion forward finds and great price. Whether it's to protect their eyes from sun -- or blinding flashbulbs! — celebrities never seem to be without their Trend Bungalow sunglasses.

See who's wearing Trend Bungalow Eyewear Brands on the red carpet and all around town »

friends + freebies