Photo Consent Form (sample)

I hereby grant [your name] permission to use my likeness in a photograph in any and all of its publications, including website entries,
without payment or any other consideration. I understand and agree that these materials will become the property of [your name] and
will not be returned. I hereby irrevocably authorize [your name] to edit, alter, copy, exhibit, publish or distribute this photo for purposes
of publicizing [your name]'s programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished
product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other
compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge [your name]
from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons
acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I am 21 years of age and am competent to contract in my own name. I have read this release before signing below and I fully
understand the contents, meaning, and impact of this release.

_______________________________________________________________

(Signature)

_______________________________________________________________

(Printed Name)

___________________

(Date)

If the person signing is under age 21, there must be consent by a parent or guardian, as follows:

I hereby certify that I am the parent or guardian of _________________________, named above, and do hereby give my consent
without reservation to the foregoing on behalf of this person.

_______________________________________________________________

(Parent/Guardian's Signature)

_______________________________________________________________

(Parent/Guardian's Printed Name)

____________________

(Date)