Social Media Photo Release Form

Social Media Photo Release Form
Name*
First NameLast Name
Birth Date
MonthDayYear
Gender
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Authorization and Release
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 nicknameI consent to the use of my photographs anonymously.
Please check the boxes regarding your preference.
I authorize ACME Photo to take my photographs.I authorize ACME Photo to use my photos on Facebook, Twitter, Instagram, and other social media platforms.I authorize ACME Photo 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 ACME Photo.I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms.
Signature
Clear
Date Signed
MonthDayYear
Date
Should be Empty:

Authorization and Release