Social Media Photo & Video Release Form

Name *

First Name

Last Name

Can We Use Your *

Complete Name

First Name

Nickname

Anonymous

I Authorise Breathe Pole Dance Academy Hillcrest *

to take my photos/video's regarding my experience with them. (videos/photos can be taken during class times)

to use my photos on Facebook, Instagram, and other social media platform.

to edit, alter, copy, or distribute the photos for social media advertising and marketing.

I agree that the photos belong to {Addictive Pole Fitness Hillcrest}.

I understand that I will not receive any monetary compensation.

Date *

MM

DD

YYYY

By ticking this box you agree to the all of the above.... *

I agree