Minor Model Release Form

Creating Lasting Memories Through Beautiful Photography.

Guardian-signed release for photography of minors.

BTL-PBL-04.004

Form

Vol 04 — Legal, Risk & Compliance

Minor

Minor's full legal name *

Minor's date of birth *

Home address *

Guardian full legal name *

Relationship to minor *

Email *

Phone *

Government ID type & number *

Shoot date *

Shoot location *

Description of imagery *

Guardian consents to photography of the named minor *

Yes / N/A

Guardian consents to the permitted uses described *

Yes / N/A

Guardian signature *

Date *

Witness signature

Prepared by

Name · Title · Date

Reviewed by

Name · Title · Date

Approved by

Owner · Katheryn L. Wilkins · Date

Controlled document — BTL-PBL-04.004. Complete all required fields (marked *). Retain per Volume 15 retention schedule.