Social Media Photo & Video Release Form

Social Media Photo & Video Release Form
Name*

First NameLast Name
Birth Date

MonthDayYear
Gender
Email
example@example.com
Instagram Handle
example@example.com
Authorization and Release
I authorize Fiat Lux Visuals to take my photographs.I authorize Fiat Lux Visuals to use my photos on Facebook, Twitter, Instagram, and other social media platforms.I authorize Fiat Lux Visuals 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 Fiat Lux Visuals.I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms.
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 a nicknameI consent to the use of my photographs anonymously.
Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Authorization and Release