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Social Media Photo/Video Release Form
Name
*
First Name
Last Name
Age
*
Date of Birth
*
MM
DD
YYYY
Gender
*
Gender
Female
Male
Non-Binary
Rather Not Say
Email
*
Phone
*
Country
(###)
###
####
Email
*
Address
*
Street Address, City, State/Province, Postal/Zip Code
Authorization, Release, and Content
Can Solo Scoop Creamery, LLC use your name?
*
Complete Name
First Name
Nickname (enter nickname below if you've checked this box)
Anonymous
Nickname (if applicable)
Please check all boxes.
*
I authorize and grant Solo Scoop Creamery, LLC to take use my photos or videos for social media marketing purposes.
I grant Solo Scoop Creamery, LLC the authority to use photos and/or video of myself and/or my likeness on Facebook, Twitter, Instagram and other social media platforms.
I allow Solo Scoop Creamery, LLC to edit, alter, copy, or distribute the photos for social media advertising and marketing.
I understand that I will not receive any monetary compensation.
Thank you!