Model Consent Form

Portland Blues & Jazz Dance Society 

This form is for the model, the person/people depicted in the pictures submitted for the contest, to consent to their image being used in the photo submitted. If multiple photos are submitted, you only need to sign one form per contest.

In signing below, I grant permission to the Portland Blues & Jazz Dance Society to reproduce any photographs I appear in for self use or self promotion in publications, which may include, but are not limited to, websites and flyers, without any compensation given to me.

I confirm that I am at least 18 years old.