Girls Up Loud Photo Release Form 

I hereby grant Girls Up Loud and its agents the right to photograph my dependent and use the photo and/or other digital reproduction of him/her or other reproduction of his/her physical likeness for publication processes, whether electronic, print, digital or electronic publishing via the internet. I release all claims against Girls Up Loud with respect to copyright ownership and publication including any claim for compensation related to use of the materials. 

Dependent Printed Name *
Dependent Printed Name
Dependent Address *
Dependent Address
Rights to Assign *
I certify that I am a custodial parent or guardian and have the aforementioned rights to assign.
By typing your name below, you are confirming that you are the Parent/Guardian of the dependent listed above and are giving your consent.
Parent/Guardian Address *
Parent/Guardian Address
Date *
Date