Business Address - City, State Zip
Business Phone - Business Fax
E-mail: - Website:
PHOTO RELEASE FORM
Subject's name: ____________________
We, ___(insert names of parents/guardians)___ of __(insert name of minor) __, 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 audiovisual presentations, promotional literature, advertising, or in other similar ways.
CIRCLE ONE: Professional Name of Subjects MAY/MAY NOT be given.
..........................(insert professional name)
We hereby warrant that we are over eighteen (18) years of age, and are competent to contract in our own names.
Names of Above (please print): _________________________
City: __________________________ State/Zip Code: _______
Primary contact can be contacted at (circle one): work home
(optional) E-mail: ____________________________________
Disclaimer: Above information is held in confidence and is never released or sold.