Child Model Release and Media Permission
Please Select One
YES — I GIVE PERMISSION (check box below)
I certify that I am the parent or legal guardian of the child named above and have the legal authority to provide this permission.
I authorize Photography by Niki LLC and Montgomery Chick-fil-A, along with their employees, contractors, representatives, licensees, successors, and assigns, to photograph and record my child during this event.
I give permission for my child’s photographs, video, voice, image, and likeness to be edited, reproduced, displayed, published, and used for lawful advertising, marketing, publicity, portfolio, promotional, and community-relations purposes in any media now known or later developed. This includes social media, websites, paid advertisements, email, printed materials, restaurant and studio displays, signage, press releases, publications, and video or broadcast media.
I understand that:
My child’s full name will not be published.
I will not receive additional payment or compensation.
Images published online may be copied or shared by others.
The authorized businesses may crop, retouch, resize, or add text and graphics to the images.
I release the authorized businesses from claims arising from the uses permitted by this release.
I may withdraw permission in writing for future new uses, but withdrawal will not require the removal or recall of materials already created, published, printed, distributed, or shared.
NO — I DO NOT GIVE PERMISSION (check box below)
I do not authorize my child’s photograph, video, voice, image, or likeness to be used for social media, advertising, marketing, portfolio, publicity, or other promotional purposes.
My child may still be photographed solely to create and deliver the complimentary event portrait and for necessary internal recordkeeping, editing, delivery, and backup purposes.
Choosing “No” will not prevent my child from participating or receiving the complimentary portrait.