Photo Release Form

Permission to use your photo

I hereby authorize PFLAG of Norman, and its representatives and agents, to use, reproduce, or distribute: (check all that apply)

my photograph or photographic likenessvideo taped imagetestimonial

individually or incorporated into any written or online documents to be used for any lawful purpose including but not limited to:

• Advertising / Promotions
• Press Coverage
• Social Media
• Member Updates

I understand that I am not entitled to compensation for use of said photographic / videographic likeness nor input concerning its use. I understand that any written information I provide may be edited. As a result, I release the PFLAG of Norman from all liability.

If my likeness is used, I ask to be identified in the following manner:


I ask that you keep my identity anonymous

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Date:
Full Name (as signature):
Email:
Phone:

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