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PARTICIPANT QUESTIONNAIRE

Thank you for your contributions to the community of Blue Springs! To be considered for this project, please complete the form below. If you are selected to be featured, you will be contacted by Jaime Russell of Anthem Photography to discuss and schedule your session.

Participant Name *
Participant Name
Name of Legal guardian *
Name of Legal guardian
Legal guardian must submit this form and grant image publication rights to Anthem Photography
Guardian Phone *
Guardian Phone
Please tell me more about your company/organization's role in the the community, as well as your personal contributions to the organization.
Your job, volunteer efforts, etc. - details are helpful!
Ex: Number of citizens utilizing the service, amount of work performed per year, estimated social impact, etc.
Please include full name(s) with contact info (if you have it), and a brief description of his or her community contributions. Or send him/her a link to this page to complete this questionnaire!
Photo release *
To be featured in this project, a release granting Anthem Photography publication rights is required. By checking below, you acknowledge that you allow the photographer to upload images of the above named minor and responses to the questions above online, use on social media, and to use the images and responses in electronic and print media in perpetuity.

 

Anthem Photography  |  1133 W Main St, Suite 200, Blue Springs, MO 64015|  816-914-2651