Photo Release Form

Name*

First NameLast Name

Birth Date

MonthDayYear

Gender

Phone Number

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

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 Robert Hunt Chapel to take my photographs.I authorize Robert Hunt Chapel to use my photos on Facebook, Twitter, Instagram, and other social media platforms as well as any print materials the parish generates.I authorize Robert Hunt Chapel 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 to Robert Hunt Chapel.I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms or print materials.I agree to the use of my photos ONLY on print materials.I wish to exclude my children from this photo release.

Signature

Date Signed

Date

Robert Hunt Chapel Photo Release Form

Authorization and Release