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Name
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First Name
Last Name
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2
Phone Number
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3
Email
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example@example.com
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4
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 nickname
I consent to the use of my photographs anonymously.
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5
Please check the boxes regarding your preference.
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I authorize Miller Rose Photography to use my photos on Facebook, Twitter, Instagram, and other social media platforms.
I authorize Miller Rose Photography to edit, alter, copy, or distribute the photos for social media platforms, i.e. Facebook, Instagram, etc. to advertise and for marketing.
I authorize Miller Rose Photography to edit, alter, copy, or distribute the photos for advertising and marketing on her website, Millerrosephotography.com.
I authorize Miller Rose Photography to edit, alter, copy, or distribute the photos for advertising and marketing on marketing materials such as, but limited to, flyers, info packets, signage, email newsletters, etc.
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6
Please check the boxes regarding your preference.
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I authorize Miller Rose Photography to use my EMAIL ADDRESS to send promotions and updates. **Miller Rose Photography will not spam you and you can unsubscribe at any time.
I authorize Miller Rose Photography to use my PHONE NUMBER to send promotions and updates.**Miller Rose Photography will not spam you and you can unsubscribe at any time.
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7
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Date Signed
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Date
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