Photography and Social Media Release
Name
*
First Name
Last Name
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Authorization and Release
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
What is your preference regarding the use of your name?
I consent to the use of my name.
Please check the boxes regarding your preference.
I authorize Circle B Corral, LLC Photo to take my photographs for use on their website and social media platforms.
I agree that the photos and all intellectual property rights of the photos belong to Circle B Corral, LLC.
I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms.
Signature
Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: