Photo Release Form — Rev. 134FDFD

Signer information

Full name *

Address *

A — Subject of photographs

My likeness, image, and appearance The likeness, image and appearance of my child

Child's name *

The likeness, image, and appearance of another individual

Individual's name *

Event / Activity name *

Event / Activity date(s) *

B — Grant of rights

C — Ownership

D — Compensation (Check one)

I acknowledge that I am not entitled to any compensation, royalties, residuals, or any other form of payment in connection with the Photos. I acknowledge that I have voluntarily agreed to provide the Photos in exchange for the following:

Description of exchange *

E — Release & discharge

F — Legal capacity (Check one)

I represent that I am at least 18 years of age and have the full legal capacity to execute this Photo Release Form. I represent that I am the parent or legal guardian of the named subject and have the full legal capacity to execute this Photo Release Form on their behalf.

Minor's name *

G — Acknowledgment

H — Governing law

I — Severability

Signature *

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Your signature here

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Date