Business Name
Business Address - City, State Zip
Business Phone - Business Fax
E-mail: - Website:
Date
PHOTO RELEASE FORM
Subject's name: ____________________
I, ___(signee)___, hereby give __Business Name__ and their legal representatives and assigns, the right and permission to publish, without charge, photographs taken
on (Month/Date/Year) _______________
at (Locations or Events) _____________________________________
________________________________________________________
________________________________________________________.
These photographs may be used in publications, including electronic publications, or in audio-visual presentations, promotional literature, advertising, or in other similar ways.
CIRCLE ONE: Professional Name of Subjects MAY/MAY NOT be given.
..........................(insert professional name)
I hereby warrant that I am over eighteen (18) years of age, and am competent to contract in my own name.
Signature: ________________________________________
Month/Date/Year: _________________________________
Address: _________________________________________
City: ___________________ State/Zip Code: _______
If necessary, I can be contacted at (circle one): work home
Telephone: _________________________________________
(optional) E-mail: ____________________________________
Photographer: _______________________________________
Disclaimer: Above information is held in confidence and is never released or sold.
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