Social Media Release Form

PCG LLC, Social Media Release Form

Promotions
Name

First Name Last Name
Profession or Artist Name
Date of Birth

Month Day Year
Date
Phone Number
Email
example@example.com
Website
example@example.com
Instagram
example@example
Twitter
example@example
Other
example@example
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Authorization, Release, and Consent
Can we use your name?

Complete name First name Nickname
Type a question

I authorize and grant PCG LLC to take or use my photos regarding my experiences with them. I grant PCG LLC to use my photos, music, likeness, comments and interviews on Facebook, Twitter, Instagram, and other social media platform. I allow PCG LLC to edit, alter, copy, or distribute the photos for social media advertising and marketing. I agree that the podcast interviews and articles belong to PCG LLC. I understand that I will not receive any monetary compensation from PCG LLC promotions, and release PCG LLC from liability from lawsuits concerning royalties, compensation, fees. or dues that come from promotional material provided. When form is submitted without a digital signature, this will still be a binding agreement between the party listed and PCG LLC.
Date Signed

Month Day Year
Date
Signature (use mouse or touch screen to sign, hold left click and move mouse to sign)
Should be Empty:

PCG LLC, Social Media Release Form