Photo and Video Marketing Consent Form
Please complete this form to provide your consent for the use of your photo and/or video in marketing materials. Your responses are required to process your permission accurately.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization/Company Name
*
Date of Consent
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Media Consented To
*
Photo
Video
Both Photo and Video
Where may your photo/video be used?
*
Company website
Social media channels
Printed marketing materials
Presentations
Other
Duration of Permission
*
Please Select
One-time use
One year
Two years
Indefinite
Limitations or Restrictions (optional)
Submit Consent
Should be Empty: