Name *

First Name

Last Name

Date Of Birth *

MM

DD

YYYY

I allow Electrum Photography to use the final images from our photo shoots for the purposes of online advertising (eg. their website) and/or social networking (eg. Instagram) with credit and tagging to my prefered profile/page.

PLEASE NOTE: Electrum Photography will always ask for the client’s consent to use your image in anyway stated above or otherwise before doing so out of courtesy, regardless of selection.

Yes

No

I allow Electrum Photography to use the final images from our photo shoots for the purposes of print mediums (eg. Magazines) with credit and tagging to my prefered profile/page.

PLEASE NOTE: Electrum Photography will always ask for the client’s consent to use your image in anyway stated above or otherwise before doing so out of courtesy, regardless of selection.

Yes

No

Electrum Photography will maintain the copyright for all photographs taken by them. Electrum photography hereby grants the client the permission to use the final images for promotional and social use, however not for the sake of resale (eg. prints or merchandise) unless Electrum Photography grants consent. By checking the box below, I grant to Electrum Photography, its representatives and employees the right to take photographs of me. I represent that I am at least 20 years of age (and can provide proof of age), have read and understand the foregoing statement, and am competent to execute this agreement. *

I Agree