Social Media Photo Release Form

Name*

First NameLast Name
Social Media Photo/Video Release Form
Birth Date

MonthDayYear
Gender
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Authorization and Release
What is your preference regarding the use of your name?

I consent to the use of my complete name.I consent to the use of my first name only.I consent to the use of my nicknameI consent to the use of my photographs anonymously.
Please check the boxes regarding your preference.

I authorize Black Diamond Beauty Photo to take my photographs.I authorize Black Diamond Beauty to use my photos on Facebook, Twitter, Instagram, and other social media platforms.I authorize Black Diamond Beauty to edit, alter, copy, or distribute the photos for social media advertising and marketing.I agree that the photos all intellectual property rights of the photos belong Black Diamond BeautyI agree that I will not receive any monetary compensation for usage of my photographs in social media platforms.
Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Authorization and Release