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Date of Shoot
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Minor's First Name
*
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Minor's Last Name
*
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Minor's Birthdate
*
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Minor's First Name
🛈
Minor's Last Name
🛈
Minor's Birthdate
+
Minor's First Name
🛈
Minor's Last Name
🛈
Minor's Birthdate
+
Minor's First Name
🛈
Minor's Last Name
🛈
Minor's Birthdate
+
Minor's First Name
🛈
Minor's Last Name
🛈
Minor's Birthdate
+
Parent or Guardian's First and Last Name
*
Street Address
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City
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State
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Zip Code
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Phone Number
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Email Address
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Referred By:
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Only check boxes below if you DO NOT wish to grant permission to Forever Captured Images/ Kristy Ambrogio the right to use photographs for the purposes stated below.
I DECLINE permission to use any photographs taken during said photo shoot for purposes of:
printed advertising
social media advertising
promotional trade
exhibition
website
all of the above
I have read and understand the policy above.
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clear
Today's Date
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Please initial one of the follow
*
YOU MUST CHOOSE ONE
I hereby acknowledge and represent that I am over the age of eighteen years of age and that I have read and understand this release.
YOU MUST CHOOSE ONE
I hereby acknowledge and represent that the Subject is a minor and that I am the parent or duly authorized representative of the Subject and that I have read and understand this release.
YOU MUST CHOOSE ONE
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