Client Model Release Form & Questionnaire

Please fill out at least 48 hours prior to your session! Thank you!

Parent's name (mom) * First Last
Parent's name (dad) * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Referred by
Email *
Phone * - ### - ### ####
Child(ren) name and age (DOB) *
Session Type *
Maternity Newborn Family/Senior/Other
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!! :)
Newborn Sessions: What is the sex of your baby?
Boy Girl
Newborn Sessions : If you are pregnant with twins or triplets please list sex of your babies.
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 you have a balance, the remaining balance is due 48 hours before your session.

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.

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. *
I agree