Newborn Model Release Form & Questionnaire
Newborn Model Release Form & Questionnaire
Please fill out at least 48 hours prior to your session! Thank you!
Parent's name (mom)
Parent's name (dad)
Address Line 2
Select a State
District of Columbia
State / Province / Region
Postal / Zip Code
Who may we thank for Referring you?
Child(ren) name and age (DOB)
Newborn Sessions : What colors are you drawn to or would like to see used during your session? I generally use two colors.. You choose one and I'll choose one!! :)
What is the sex of your baby(ies)?
More than 2 babies please use comment section below! :)
Newborn Sessions : If more than two babies please list the sex of your babies here! :)
Comments or Suggestions. Please use this space if you'd like me to do anything specific for your session (pose, props, etc). If there is a particular pose that you absolutely love or one that you don't care for, please list it here. In addition, please list your baby's birth stats here! (Time of birth, weight & Length)
If applicable, your $150 creative fee as well as your minimum purchase requirement of $350 MUST be paid prior to your session day. Your minimum purchase requirement ($350) will be deducted from your chosen package at the time you place your order. Pricing can be found at www.chaunva.com/investment. Please take the time to review all options. (If you desire a payment plan this MUST be discussed PRIOR TO FILLING OUT THIS FORM!)
(THE MINIMUM PAYMENT PORTION "DOES NOT" APPLY TO GIFT CERTIFICATE HOLDERS!) (GIFT CERTIFICATES ARE BLUE AND WHITE OR TANGERINE AND BROWN ON AN "EMBOSSED" GIFT CARD)
(MINIMUM PAYMENT REQUIREMENT "DOES" APPLY TO BABIES R' US GIFT CARD HOLDERS)
I am a gift certificate holder! (Gift certifcate must be surrendered at session!) (Actual gift certificate is blue and white or tangerine and brown on an "embossed" gift card!)
You may pay your minimum via credit card by calling my assistant, Cindy, at 817-941-7818 or request an Invoice be sent to your email for payment. The total minimum purchase amount of $350 and creative fee of $150 with taxes is $541.25. If your creative fee has already been paid your minimum purchase requirement amount with taxes is $378.88. Please select your preference below.
Please send invoice to my email address
I will call to pay.
I will be paying cash.
I am a GIFT CERTIFICATE holder (Blue and white card ONLY!)
You have the option to make your selections and place your order from your baby's images the day of the session. Please select your preference below!
I'd like to make my selections and place my order immediately following the session.
I'd like to set an appointment to return to make my selections and place my order.
Client agrees that all images shall be printed through Chaunva LeCompte Photography or its authorized representative. Client shall not print, copy, or otherwise reproduce any of the images without the express written consent of Chaunva LeCompte Photography.
Client’s Right to Use Materials: Client is obtaining prints for PERSONAL USE ONLY and Client shall not sell said prints or authorize any reproductions of the prints by any third party unless such reproduction is authorized in writing by Photographer. If Client purchases limited, non-exclusive usage rights to digital files, such usage shall be for personal, non-commercial use only. (This is to include any and all images from Chaunva LeCompte Photography.)
Copyright Ownership: Chaunva LeCompte Photography (the “Photographer”) owns all rights and title to the copyrights in all images and photographic materials created on behalf of the Client and shall have the exclusive right to make prints or reproductions. Photographer reserves and the Client expressly grants the express right of Photographer to make reproductions and use the photographs and images of Client and/or Client's minor children listed above for use in connection with Photographer's portfolio, samples, self-promotions, entry in photographic contests or art exhibitions, advertising and promotion, books, magazines, illustrations, editorial use, or for display within or on the outside of the Photographer's studio, on Photographer's website, including on all printed materials, media on the Internet, and any current or future digital media. Photographer reserves the right to sell and distribute such materials upon written notice to Client at the address listed above. Nothing herein shall be deemed as a release, transfer, assignment or other disposal of Photographer’s rights in the materials.