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This is a typical release form used to secure permission to use an individual’s likeness with or without identification.
From Public Relations Writing & Media Techniques (Fourth Edition) by Dennis Wilcox.
Sample Photo Release Form
Name or Organization
City, State, Zip
Permission to Use Photograph
I grant to [insert name or organization], the right to take photographs
of me and my family in connection with the above-identified event. I
authorize [insert organization], its assigns and transferees to
copyright, use and publish the same in print and/or electronically.
I agree that [insert name or organization] may use such photographs
of me with or without my name and for any lawful purpose, including
for example such purposes as publicity, illustration, advertising, and
I have read and understand the above:
Printed name ______________________________
Signature, parent or guardian _______________________
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