Name *

First Name

Last Name

Minor's Name

If applicable to the photographs taken

First Name

Last Name

What date did I take pictures of you? *

Try your best:)

MM

DD

YYYY

Phone

(###)

###

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Indicate "YES" or "NO" to the following: I grant Anne Marie Silvis Photography use of my photographs for any legal use, including but not limited to, publicity, copyright purposes, illustration, advertising, and web content. *

YES

NO

Indicate "YES" or "NO" to the following: I understand that no royalty, fee or other compensation shall become payable to me by reason of such use. *

YES

NO

Indicate "YES" or "NO" to the following: I consent my signature via this electronic form. *

YES

NO