Optional Authorization

Client Photo & Media Consent Form

Optional authorization for use of client photographs and personal media.

AB Photo Memories treats client photographs and personal media as private. No promotional use is authorized unless you affirmatively grant permission on this form. Declining permission will not affect your ability to receive services.

Client Information

Client name

Project / collection

Phone

1. Choose One

Nothing is selected for you. Please choose one option below.

I GIVE permission to AB Photo Memories to use only the photographs/media and uses I specifically authorize below.I DO NOT GIVE permission for AB Photo Memories to use my photographs, videos, personal media, project images, or before-and-after examples for advertising, social media, website galleries, portfolio examples, or promotional purposes.

6. Restrictions or Special Instructions

7. Authorization

By signing below, I confirm that I am authorized to grant the permissions selected on this form. I understand that permission is limited to the selections and restrictions I have made above. I understand that declining permission does not affect my eligibility for AB Photo Memories services.

For media I have authorized, I grant AB Photo Memories permission to reproduce, display, publish, or otherwise use that approved media only for the approved purposes selected above. AB Photo Memories will not knowingly sell the underlying client media itself or transfer ownership of my original photographs or personal media through this release.

8. Changing or Withdrawing Permission. I may contact AB Photo Memories in writing to request that future promotional use stop. I understand that withdrawal may not be able to reverse materials already printed, distributed, published, or shared before the withdrawal was received, but AB Photo Memories will make reasonable efforts to stop future use under its control.

Signature (type your full name)

Printed name

Your submission is dated and time-stamped automatically when you send it.

Your consent record is stored privately. No photographs or media are uploaded or made public through this form.

AB Photo Memories Privacy Standard

Client photographs and personal media remain private unless the client has affirmatively authorized promotional use. A service agreement, consultation request, website submission, or acceptance of the Privacy Policy is not a media release.

This form is a business template and is not legal advice. Consider having an Arizona attorney review the final release before routine client use.