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I/We ______________________________________________________________________________
[Print Business Name]
grant permission to Modern Photo Creations to reproduce the copyrighted images specified here.
I understand the images will be reproduced on a photo card and may be used as a form of company
advertisement. For example, website, brochures, displays, etc.
Describe/List Images:
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_________________________________________________________________
_________________________________________________________________
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| ___________________________________ |
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___________________________________ |
| Photographer's Signature |
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Photographer's Signature |
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| ___________________________________ |
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___________________________________ |
| Date |
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Date |
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| ___________________________________ |
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___________________________________ |
| Business Phone |
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Business Phone |
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