image publication release

MODEL/SUBJECT NAME *
MODEL/SUBJECT NAME
BIRTHDATE *
BIRTHDATE
PARENT OR LEGAL GUARDIAN NAME (REQUIRED IF MODEL/SUBJECT IS UNDER 18 YEARS OF AGE ON DATE OF PHOTO SESSION)
PARENT OR LEGAL GUARDIAN NAME (REQUIRED IF MODEL/SUBJECT IS UNDER 18 YEARS OF AGE ON DATE OF PHOTO SESSION)
PHONE *
PHONE
PUBLICATION RELEASE *
Please check the box below to accept the terms of the publication release
PRINTS AND DIGITAL IMAGES *
Please check the box below to accept the prints and digital images policy.
DIGITAL SIGNATURE
By clicking "sign and submit" as your digital signature, you acknowledge that you have read and agree to the terms of this release and are authorized to grant permission for publication as the model or legal guardian of the model listed above.