CONSENT & RELEASE CONSENT & RELEASE FORM Please fill out the form below. Name * First Name Last Name Email * Phone * (###) ### #### I, the undersigned model, hereby grant permission to XO Influencer LLC to take and use photographs and/or video recordings of me during the photo shoot described above. I understand that these images may be used for the following purposes (check all that apply): * Website and social media platforms Marketing materials (brochures, flyers, etc.) Online publications Print publications Other: (Brand deals, Media Kit, Portfolio, etc.) I confirm that I am at least 18 years of age, and I have the right to enter into this agreement. If I am under 18 years of age, I will provide a parent/guardian's signature below. * Agree Disagree I understand that the photographs may be used for promotional purposes and may be shared publicly. I waive any right to inspect or approve the finished images or any printed or electronic matter that may be used in conjunction with them. * Agree Disagree I waive any right to royalties or other compensation arising or related to the use of the photographs taken of me. * Agree Disagree I release XO Influencer LLC from any liability related to the use of my image, including but not limited to claims for defamation, invasion of privacy, and copyright infringement. * Agree Disagree Electronic Signature * Date MM DD YYYY Parent/Guardian Electronic Signature (if under 18) Date MM DD YYYY Contact Information for Parent/Guardian (if applicable) Thank you! xo
