You are on page 1of 1

Sanjanaa Ellur

sellur@uci.edu
(949)2476409
PHOTOSHOOTCONSENTFORM
Subject(personinphoto):_____________________________________________
Location:___________________________________________________________

Note:Thisisalegalbindingagreementpleasedonotsignitifyoudonotunderstandit.

RighttoUse
IgrantSanjanaaEllur,therighttotakephotographsofmeandmypropertyinconnection
withtheaboveidentifiedsubject.IauthorizeSanjanaaEllurtocopyright,useandpublishthesameinprint
and/orelectronically.

Howphotoswillbeused
IagreethatSanjanaaEllurmayusesuchphotographsofmewithorwithout
mynameandforanylawfulpurpose,includingbutnotlimitedtoforexamplesuchpurposesaspublicity,
illustration,advertising,andWebcontent.

LiabilityWaiver
IwaiveSanjanaaEllurofallliabilityofassociatedwiththisphotoshoot.Thisincludes,but
isnotlimitedtoloss/damageofpersonalitemsaswellasinjuriestoindividuals,includingmyself.

Fees
Fees(Donations)arenotdueuntilthesubjecthaspreviewedthephotosandiscontentwiththe
results.Paymentconstitutescontentmentwiththephotos.Sinceyougettoseetheworkbeforeyoupay,I
cannotofferanyrefundsorpriceadjustmentsafterpaymentissubmitted.

Ihavereadandunderstandtheabove:

NameofSubject:________________________________________________
DateofBirth:__________________________________
AdditionalName(s)ofSubject(s)Included:
___________________________________________________________________________
Address:___________________________________________________________________
City:_____________________State:_________________________Zip:_______________
Phone:_________________________Email:_______________________________________
ParentorGuardian'sName(ifapplicable):
___________________________________________________________________________
Signature(parentorguardian'ssignaturerequiredifsubjectisundertheageof18):

____________________________________________________Date:_____________

PhotographersSignature:Date:_________________

___________________________________

You might also like