KICKPICS PHOTO RELEASE FORM

Permission to Use Photographs

I, the undersigned, do hereby understand that all photographs taken at this photo shoot are the property of Stace Sanchez and KICKPICS, LLC. I give Stace Sanchez and KICKPICS, LLC the irrevocable right to use my name and these photographs for reproduction in any print or electronic medium for purposes of advertising, sell, trade, display, exhibition, competition or editorial use. I have read this release and understand and agree to its terms. I affirm that I am at least 18 years of age or am the legal guardian of the below named student.

Model’s Name:	The Model’s Name is required.
Model’s Email:	The Model’s Email is required.Invalid format.
Model’s Birthday (MM/DD/YY):	The Model’s Birthday is required.Invalid format.
Model’s Address:	The Model’s Address is required.
Model’s City:	The Model’s City is required.
Model’s State:	The Model’s State is required.
Model’s Zip Code:	The Model’s Zip Code is required.Invalid format.
Today’s Date (MM/DD/YY):	The Model’s Zip Code is required.Invalid format.
Parent/Guardian Name: (If you are under 18 years old)
Model: By typing your initials, this serves as your electronic signature:
Guardian: By typing your initials, this serves as your electronic signature:
After you hit SUBMIT, please wait for a confirmation saying that it has been sent. Do not close this window until then.

Stace Sanchez - kickpics@gmail.com

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