Social Media Photo Release Form
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Phone Number
-
Area Code
Phone Number
Email
example@example.com
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
Anonymous
I authorize and grant {Salt and Pine llc} to take my photos regarding my experiences with them.
I grant {Salt and Pine llc.} to use my photos on Facebook, Twitter, Instagram, google and other social media platform.
I allow {Salt and Pine llc.} to edit, alter, copy, or distribute the photos for social media advertising and marketing.
I agree that the photos belong to {Salt and Pine llc}.
I understand that I will not receive any monetary compensation.
Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
Should be Empty: