Social Media Photo/Media Release Form

Social Media Photo Release Form
Name

First Name Last Name
Age
Date of Birth

Month Day Year
Date
Gender
Phone Number

Area Code Phone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Authorization, Release, and Consent
Can we use your name?

Complete name First name Nickname Anonymous
I authorize and grant DANCEON8 to take my photos/videos regarding my experiences with them. I grant DANCEON8 to use my photos/videos on Facebook, Twitter, Instagram, and other social media platform. I allow DANCEON8 to edit, alter, copy, or distribute the photos/Videos for social media advertising and marketing. I agree that the photos/videos belong to DANCEON8. I understand that I will not receive any monetary compensation.
Signature

Clear
Date Signed

Month Day Year
Date
Should be Empty:

Social Media Photo Release Form