Little Darling's Modeling Agency Registration Form
P.O. Box 19457 ~ Baltimore, MD 21206
Tel: 410-488-0975 ~ Fax: 410-488-7254
I. GENERAL INFORMATION
Child's Full Name:______________________________________________
Parent/Guardian's Full Name:____________________________________
Address:_______________________________________________________
City, State Zip code:____________________________________________
Tel:(Home)________________________(Work)______________________
Pager:_______________________Cellular Phone:____________________
E-mail:________________________________________________________
II. PERSONAL INFORMATION
Date of Birth of Child:__________________________________________
Social Security #(payroll purposes):_______________________________
Gender:___________ Ethnic Look:________________________________
Hair Color:_____________________ Eye Color:_____________________
Height:_____________Weight:____________Shoe Size:_______________
Clothing Size:__________________________________________________
Please select the areas you want your child to work in:
Print Work Film/Video TV Commercials Acting Fashion Modeling
Modeling Experience:______________________________________________
__________________________________________________________________
__________________________________________________________________
Requirements:
Submit the Registration Form, along with four (4) photographs;
one(1)head shot,(1) full body shot, and two (2) candid shots.
Since this is a pre registration, we do not require professional
photos. Any size and type will be excepted. If your child is a
professional or experienced model and have composite cards, feel
free to submit a copy with this form.
These photographs NEED to reflect your child's current look.
Release (to be signed & completed by the parent or legal guardian):
I, (print your full name)_______________________________________ certify
that all of the above information is true and accurate to the best of
my knowledge. I understand my child will be posing for modeling portfolio
pictures to be used by Little Darling's Modeling Agency and I hereby
release Little Darling's Modeling Agency from any and all future claims
regarding said photographs. I hereby release Little Darling's Modeling
Agency to publish any of my child's photos as they see fit, for promotional
or advertising use, or in any medium that promotes my child's availability
as a model.
Signed:__________________________________Date:_______________