Social Media Photo Submission and Release Form

Name*

First NameLast Name

Birth Date

MonthDayYear

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What is your preference regarding the use of your name?

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 my names as provided belowI consent to the use of my photographs anonymously.Other

Please check that you agree to all boxes to be considered.

I authorize KetchingOn to use my photos on Facebook, Twitter, Snapchat, and other social media platforms.I authorize KetchingOn 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 KetchingOn.I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms.I agree that I am the legal guardian of and give consent on behalf of any minors in the photo

Other names to call out!

Feedback

Signature

Date Signed

Date

Social Media Photo Release Form

Authorization and Release