Photo and Video Release Form
For valuable consideration received, I grant to black shell studio ("Photographer") and his/her legal representatives and assigns, the irrevocable and unrestricted right to use and publish photographs of me, or in which I may be included, for editorial, trade, advertising, and any other purpose and in any manner and medium; and to alter and composite the same without restriction and without my inspection or approval. I hereby release Photographer and his/her legal representatives and assigns from all claims and liability relating to said photographs.
Client Information
Do you understand and agree to all statements above.
Yes
No
Full Name
First Name
Last Name
Date of Birth
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Month
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Day
Year
Date
Age
Email
example@example.com
Phone Number
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Area Code
Phone Number
Location Survey
City and State where you reside?
Authorization and Release Agreement
*
I allow {black shell studio} to take or capture my photos and videos.
I understand that I will/ will not receive any monetary compensation.
I authorize {black shell studio} to distribute and reproduce the materials for the following purposes: Portfolio showcase, advertising, marketing, branding, educational, digital promotions, internet videos, online courses, media, other commercial or non-commercial purposes
I grant {black shell studio} to use my photos and videos on Youtube, Vimeo, Facebook, Twitter, Instagram, and other social media platform.
I do not permit {black shell studio} to use these materials that can harm my reputation or others.
I understand that the materials taken on this event will be covered with this document only.
I release {black shell studio} from all liability and obligations from any claim for injury, illnesses, claims, or demands.
I/We, the undersigned, hereby agreed that we have read this agreement and bounded by it.
Client Signature
Date Signed
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Month
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Day
Year
Date
Submit
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