Social Media Release Form
Please complete this form to grant permission for the use of your image, video, or content on our social media platforms.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Are you completing this form for yourself or on behalf of a minor?
*
Myself
On behalf of a minor
If you are completing this form on behalf of a minor, please provide your full name and relationship to the minor.
Description of the image, video, or content to be released (e.g., event name, type of media)
*
Which social media platforms may your image, video, or content be used on?
*
Facebook
Instagram
Twitter/X
YouTube
LinkedIn
Other
Purpose of use (select all that apply)
*
Promotional materials
Event highlights
Testimonials
Educational content
Other
Duration of consent
*
Please Select
One-time use only
For a specified period
Indefinitely
If you selected 'For a specified period', please specify the duration (e.g., 6 months, 1 year)
Will you receive compensation for the use of your image, video, or content?
*
No, I understand I will not receive compensation
Yes, I will receive compensation (please specify)
If compensation will be provided, please specify details
Signature
*
Submit Release
Submit Release
Should be Empty: