Name
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First Name
Last Name
Phone Number
Format: (000) 000-0000.
Email
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Address
Street Address
Street Address Line 2
City
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Authorization and Release
Description of Property
Property Address (if applicable)
Please check the boxes regarding your preference.
I grant permission to Micah Heath Audio, Video, Photo, to take photographs and video recordings of the property described above.
I agree that the Photographer may use such photographs and video recordings for any lawful purpose, including but not limited to advertising, publicity, promotional materials, and other commercial uses. This release is granted without compensation to me and applies to all forms of media now known or hereafter developed.
I authorize Micah Heath Audio, Video, Photo to edit, alter, copy, or distribute the photos for social media advertising and marketing.
I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms.
I represent and warrant that I am the owner of the property described above or have the authority to grant this release on behalf of the property owner. I hereby release and discharge the Photographer, its legal representatives, and assigns from any and all claims, demands, and causes of action that I may have by reason of this authorization.
Signature
Date Signed
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Month
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Day
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Date
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