Photography consent & release form

First name*

Last name*

Email*

Date of birth*

Día

Mes

Año

I hereby give my consent to use my photographs according to the Terms & Conditions.

Confirm with your initials*

By appointment only

All faces welcome- Misses, Misters, Theys & Thems

Located in Merrick, NY, directly across from the Merrick LIRR Station.

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