The Sprouting Lens - Photo Release Form

Photo & Video Release Consent

The Sprouting Lens would like permission to use photos, videos, and audio recordings taken of you for promotional purposes.

This includes use in newsletters, flyers, posters, brochures, advertisements, websites, social media, and other marketing materials.

Do you consent to The Sprouting Lens using photos, videos, and audio recordings of you?

Yes, I consent

I agree to allow The Sprouting Lens to use my photos/videos/audio recordings

No, I do not consent

I do not wish to have my photos/videos/audio recordings used

Please select an option

Photo Release Declination Form

You have chosen NOT to consent to the use of your photos/videos.

Please complete this brief form to document your decision. We respect your choice and will not use any photos or videos of you for promotional purposes.

First Name *

Last Name *

Email (Optional)

We'll only use this to send you a copy of your declination if requested.

Date *

Signature *

Sign below using your mouse or finger

Type your full name

Please provide your signature

Step 1: Personal Information

First Name *

Please enter your first name

Last Name *

Please enter your last name

Street Address *

Please enter your street address

Street Address Line 2

City *

Please enter your city

State *

Please enter your state

Zip Code *

Please enter your zip code

Step 2: Email Verification

Email Address *

Please enter a valid email address

Step 3: Phone Verification

Phone Number *

+1

Please enter a valid phone number

Electronic Signature Consent

Notice Regarding Electronic Signatures

By signing this form electronically, you agree to conduct this transaction by electronic means. Please read the following information carefully:

Your Rights:

You have the right to receive a paper copy of this agreement. To request a paper copy, please contact us.
You may withdraw your consent to electronic signatures at any time by contacting us.
After signing, you will be able to download a PDF copy of this completed form for your records.

System Requirements:

A device with internet connection (computer, tablet, or smartphone)
A current web browser (Chrome, Firefox, Safari, or Edge)
Ability to view and save PDF files

You must consent to electronic signatures to proceed

Terms & Conditions

Permission of Use

I hereby grant permission to The Sprouting Lens for any photos, videos, or audio recordings of me to be used in and/or for any lawful promotional materials, including but not limited to newsletters, flyers, posters, brochures, advertisements, press kits, websites, social media pages, and other print and digital communications.

This authorization shall continue indefinitely and extends to all languages, media, formats, and markets, whether now known or later discovered.

No Compensation

I understand that I will not receive any monetary compensation for the use of images or sound recording.

Rights Granted

I grant The Sprouting Lens the following rights:

The right to edit, alter, copy, or distribute the images or sound recordings for any lawful purpose.
The right to use my name in connection with the images or sound recordings if they choose.

Release and Waiver

I hereby release and discharge The Sprouting Lens, its employees, agents, and representatives from any and all claims, demands, or causes of action that I or any of my heirs, representatives, executors, administrators, or any other person acting on my behalf or on behalf of my estate may have now or in the future for defamation, invasion of privacy, or violation of the right of publicity or any other right arising out of or relating to the use of the images or sound recordings.

By signing below, I acknowledge that I have completely read and fully understand the above release agreement.

Signature

Date *

Please select a date

Signature Method *

Sign below using your mouse or finger

Type your full name as it appears above

Please provide your signature