Photograph Release Form - Download as DOC

							                                  Photograph Release Form

If you are submitting a professional photo for use in the creation of photo tiles for
pendants, pins, magnets, key rings, and/or zipper pulls please print this page and ask
your photographer to complete it and return it to me by mail, fax or email (scanned
copy with signature). Your photographer may have his or her own release form and I will
gladly accept that in lieu of this form.

Please return this form (by mail, fax or e-mail) to:

Westwildwood, Inc.
1016 West Wildwood Drive
Prospect Heights IL 60070
Fax: (847) 459-4994
E-mail: Scanned copy containing signature: ann@westwildwood.com

I __________________________________________ (photographer’s name) of

___________________________________________ (name of photography studio) hereby grant

Westwildwood, Inc. the right to use the photograph(s) of _______________________________

(client's name) in the creation of the client's photo tile. I understand that these

photographs will be used only for the personal enjoyment of my client and will not be

used for commercial purposes without my further written consent.


___________________________________________________ (signature of photographer)

____________________________ (date)




___________________________________________________ (studio name, address and phone)

___________________________________________________

___________________________________________________

___________________________________________________


If you have any questions regarding this form please contact:

Ann Marie Thomas
Westwildwood, Inc.
1016 West Wildwood Drive
Prospect Heights IL 60070
Phone: 847-370-4994

E-mail: ann@westwildwood.com