Social Media Photo Release Form

Photo Release Form

NEOPHOENIX ORGANIZATION
Name of child under age of 16*

First NameLast Name
Name of parent of child above*

First NameLast Name
Birth Date

MonthDayYear
Contact information
Email
example@example.com
Authorization and Release
Consent to Photos and Images of anyone under the age of 16 shared on the neophoenix social media pages

I consent to the use of my photographs of my child on the neophoenix Organizations social media pagesI do not consent and do not want photos shared of my child
Signature

Clear
Date Signed

MonthDayYear
Date
Should be Empty:

Photo Release Form