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Contact Information: Jamie Schnable, Owner, 715-965-2517

We would like to request your consent to use photographs or video recordings of you for the following purposes:

Marketing and promotional materials (e.g., brochures, websites, and social media) Educational or informational purposes Media and press releases

Location: Free to Be Equine Center Premise Description of Activity/Event: During Sessions photo or video may be taken

By signing this form, you grant Free to Be Equine Center the right to: Use, reproduce, and distribute the images or recordings in any media, both now and in the future, without compensation. Modify or edit the images or recordings as necessary for the intended purpose. By checking the box, I do not give consent for the use of any photo, videos, or other multimedia to be used, reproduced, or distributed by Free to Be Equine Center.

Name (Printed): Signature: Date:

For Minors (Under 18): I, the undersigned parent or guardian, give permission for the above-named minor to be photographed or recorded.

Name of Parent/Guardian (Printed): Signature of Parent/Guardian: Date:

Acknowledgment: I understand that I may revoke this consent at any time by notifying Free to Be Equine Center in writing. I also understand that revoking consent will not affect any material that has already been produced.