LoadsofLogan - Model Release Form

Model Release
2257 Compliant - Consent for Production and Upload
Section I: Production Details & Roles
Legal Name (must match ID exactly)
First NameLast Name
Stage Name
Email
example@example.com
Phone Number
Area CodePhone Number
Current Physical Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Production Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Role in this production (select all that apply):
Scene Description

Section II: Ownership & Exploitation
I, the undersigned Model, acknowledge that this production is a collaborative effort. While the parties mutually own the copyright to the raw footage and final "Content," each party is hereby granted the independent, irrevocable, and unilateral right to use, publish, sell, and monetize the Content on their respective paywalled platforms (e.g., OnlyFans, ManyVids, personal studio sites) without further notice to, or financial accounting to, the other party.
Promotional Use: Use of short excerpts (teasers) on non-paywalled social media (e.g., Twitter/X) is permitted for marketing purposes.
Creative Contributions: To the extent that I provide input, direction, or technical services (editing/videography), such contributions are considered a "Work Made for Hire." Mike Piazza (MP) retains the right to use the Content in a professional production portfolio regardless of the Model's future account status.
Signature
Section III: Legal Affidavit & 2257 Compliance
FEDERAL RECORD-KEEPING NOTICE: All records required by 18 U.S.C. § 2257 are maintained by the Primary Producer, Mike Piazza, at the following address: 3367 rue de Verdun, Verdun QC H4G 1K2. The Custodian of Records is Mike Piazza.
PERFORMER SWORN STATEMENT: I swear under penalty of perjury under the laws of the United States (28 U.S.C. § 1746) and Canada that I am 18 years of age or older. I affirm that the government-issued identification provided is authentic.
ID Type (ex: Passport)
ID Number (needs to match photo)
Front of ID
Browse Files
Cancelof
Rear of ID
Browse Files
Cancelof
Photo of yourself holding your government-issued ID next to your face. Ensure both your face and the details on the ID are clearly visible
Browse Files
Cancelof

Section IV: Supremacy & Entire Agreement
ENTIRE AGREEMENT & SUPREMACY: This Agreement constitutes the entire understanding between the parties regarding the Content created on the Production Date. In the event of any conflict, inconsistency, or discrepancy between the terms of this Agreement and any other document, release, or contract signed by the parties (including studio-standard releases), the terms of THIS Agreement shall prevail and control in all respects.
Signature

Section V: Privacy Notice
Jordan Darling (JD) agrees to store all personal data (including ID scans) in an encrypted digital vault. Access is release limited to JD for legal compliance and platform verification. Records will be retained for 7 years as per industry standard and destroyed via secure digital wiping thereafter.
PRIVACY & DATA MINIMIZATION NOTICE: The personal information collected (Address, Phone, Email, ID Number) is collected solely for the purpose of legal compliance with 18 U.S.C. § 2257 and Canadian age-verification standards. Jordan Darling agrees that this data will never be sold, shared for marketing, or disclosed to third parties except as required by law or for platform verification (e.g., OnlyFans/ManyVids). You have the right to request access to your data or its correction at any time.
Section VI: Socials
(enter 'na' if you don't have an account)
Onlyfans.com/
Justfor.fans/
Other usernames (rawfuckclub, manyvids, pornhub, etc.)
Twitter/X username
Instagram username
Section VII: Certification & Sworn Affidavit
CERTIFICATION & SWORN AFFIDAVIT: I, the undersigned Model, do hereby certify and swear under penalty of perjury under the laws of the United States (28 U.S.C. § 1746) and the laws of The United States of America that I am 18 years of age or older and that all information provided in this form is true, correct, and complete. I have read and fully understand this Agreement, including the grant of rights and the supremacy of this document. I acknowledge that my electronic signature below has the same legal force and effect as a handwritten signature.
Name
First NameLast Name
Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Unlock Producer Fields?
PRODUCER’S SWORN STATEMENT (18 U.S.C. § 2257): I, Mike Piazza, do hereby certify under penalty of perjury under the laws of the United States and Canada that I have personally examined the original government-issued identification documents provided by the Model and have verified the Model’s date of birth and identity. I have further cross-referenced the provided ID with the "Day-of" selfie provided by the Model to ensure authenticity.
Reason for Rejection (Internal)
Producer Signature
Date Verified
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Model Release

Section I: Production Details & Roles

Section II: Ownership & Exploitation

Section III: Legal Affidavit & 2257 Compliance

Section IV: Supremacy & Entire Agreement

Section V: Privacy Notice

Section VI: Socials

Section VII: Certification & Sworn Affidavit