Photo Video Release Form

Release Form

Photo, video, spoken and written word permission form
This waiver grants The Leaves, Inc. permission to use your image and words (all photos, video, spoken and written word) in whatever purpose it may serve, including but not limited to all print and digital publication and distribution, including on social media. You will not be paid for the use of your images.

We reserve the right to use these photos/videos/words for The Leaves’ promotional campaigns and all future publications. However, we will not use the content in any way unrelated to The Leaves.
Name*

First NameLast Name
E-mail*
Phone*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
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I hereby give my consent
Signature*

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