Photo Release Consent Form

Please complete the form below to grant us access to use your photos on our website and/or social media sites to support our business services and show others what their results could look like.

Name

First Name

Last Name

Phone

(###)

###

####

You may use my:

First & Last name

First name

Instagram Handle

I prefer to be anonymous

What is your Instagram handle?

I grant permission to The Zen Chameleon for use of the photograph(s) or electronic media images in any presentation including social media, website use, and advertisement. I understand that I may revoke this authorization at any time by notifying The Zen Chameleon in writing or email. The revocation will not affect any actions taken before the receipt of this written notification. Images will be stored in a secure location and only authorized staff will have access to them.

I agree that the photos taken during my experience belong to The Zen Chameleon.

I understand I will not receive any monetary compensation for any images taken of me.

Please sign you full name below.