Social Media Photo Release Form
How many individuals are you signing for (INCLUDING YOURSELF)
*
Please Select
1
2
3
4
5
6
7
8
9
10
Name
*
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Authorization and Release
Please check the boxes regarding your preference.
*
I authorize PDOP to take photographs of me and those I am signing for, and use my photos on Facebook, Twitter, Instagram and other social media platforms for advertising and marketing and that PDOP retains all rights to the photos and I will receive no compensation for use of my photos.
I do not consent to the use of our photos.
What is your preference regarding the use of your name?
*
I consent to the use of our complete name.
I consent to the use of our first name only.
I consent to the use of our photographs but without our name.
I do not consent to the use of our photographs or our name.
Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: