Story/Photo Release

Better Birth Advocacy Network

Birth Story + Photo Release
Model Release
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Country
Client Phone Number *
E-mail *
example@example.com
When my story and photos are posted on social media, I would like to:

Remain Anonymous Be tagged in the Post My name published in the story but not tagged in the post
A. I hereby give to Better Birth Advocacy Network the absolute and irrevocable right and permission with respect to the photographs that they have taken of myself and/or my minor child in which he/she may be included with others: a) Retain and hold the copyright to all photos taken. b) to use for all of the following but is not limited to: promotional materials, publication, advertisements, social media, website use, etc.

B. While the story I submitted is my own, I hereby grant Better Birth Advocacy Network the irrevocable right and permission to publish, edit, and use in any way they see fit; Including but not limited to promotional materials, publication, advertisements, social media and website use.
*

I have read and understand the terms of this release with Better Birth Advocacy Network.
Signature *

Clear
Should be Empty:

Better Birth Advocacy Network