Jen Havens/The Real Life Dog Media Release

MEDIA RELEASE

During training sessions, it can be useful to document a pup’s progress. I would be grateful if you would fill in this form to give me permission to take photos/videos of your pet(s) to possibly use in printed and online publicity and social media. By granting me permission to share our work together, you are supporting my small, growing business. If you prefer I do not share photos or videos of your pets on my website, social media, emails, etc (always as tastefully and privately as possible), it's quite alright, just choose "DO NOT".
Name

First NameLast Name
Mobile Number
(000) 000-0000Format: (000) 000-0000.
Email
example@example.com
Dogs name(s) and breed:
Social media usernames (Instagram, Facebook, Twitter, etc)
Enter “none” if you aren’t a social media user.
I, FIRST NAME* LAST NAME* DO DO NOT* give permission to Jen Havens/The Real Life Dog or training assistants to take photographs and/or video of my pet(s). By choosing “DO”, the above mentioned have my permission to take photos/videos but only Jen has permission to use images, and any reproductions or adaptations of images captured by Jen or her training assistant for fundraising, publicity Jen Havens/The Real Life Dog deems appropriate. This might include (but is not limited to), the right to use them in The Real Life Dog printed and online publicity, website, social media, press releases and funding applications.
I, FIRST NAME LAST NAME DO DO NOT grant Jen Havens/The Real Life Dog the perpetual, non-exclusive right, license, privilege and authority to use Dog's name, breed, age, training progress, past behavior history and image to use in any manner, medium, form or language, worldwide, in connection with the advertising and promotion of The Real Life Dog and/or Jen Havens.
If there are any parts of this media release that you would like to amend, please enter your amendments here. For amendments to be implemented, you need to check the “DO” box in at least one of the first two items.
For example: You want to allow photos only, not video. You don’t want your dog’s name used, but are okay with photos posted on social media or Jen’s website. You want all photos and videos to be cropped for privacy purposes.
Please ask your trainer/instructor for permission PRIOR to taking any photos or video of your training sessions or workshops. DO NOT start taking photos/video without permission. If your trainer/instructor allows you to take photos/videos during training sessions or workshops, you agree to obtain permission from Jen Havens/The Real Life Dog PRIOR to sharing via email, text, or other means or posting online. Just like you, I take my privacy very seriously.
We may ask you to put your device/camera away if you do not request permission from your trainer PRIOR to taking photos/videos.
By entering your name and today's date, you understand and agree to the terms of this media release.

First NameLast Name
Date

MonthDayYear
Should be Empty:

MEDIA RELEASE