Newborn Model Release Form & Questionnaire

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

Parent's name (parent 1) * First Last
Parent's name (parent 2) * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone * - ### - ### ####
Email *
Who may we thank for Referring you?
Child(ren) name and age (DOB) *
Newborn Sessions : What two colors are you drawn to or would like to see used during your session?
What is the sex of your baby(ies)?
Boy Girl Boy/Girl Boy/Boy Girl/Girl 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)
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!) *
I have reviewed and understand pricing.
If you've had the chance to look at print, digital and package pricing please state below in the space if you already have a desired package or amount of image selections in mind. (Digital images are $75 each, 10 for $650 or a full gallery, which is 25, for $850) *
I am interested in 1 or more Specialty Composite image(s). Composite images are $100 each. (Refer to pricing to see available composite image gallery link.) I am intersted in 3-4 digital images (please use the comment section to specify number of images) Digital images are $75 each I am interested in 5 Digitals - $375 I am interested in 10 Digitals - $650 (discount per image) I am interested in 25 Digitals - $850 (props, outfits, wraps, I WANT IT ALL!) (GIFT CERTIFICATE HOLDERS) PLEASE DO NOT CHECK THIS BOX IF YOU WANT MORE THAN 1 IMAGE. Check this box ONLY if you ONLY want your free image. (When this option is chosen only 1 single pose will be done.) Please use this space if you have comments regarding your selections. If you have an idea about which package you're wanting please list it here. (Bluebonnet, Wildflower or Texas Rose package.)
I understand any outstanding balance is due the day of my session.
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. *
I agree
Thank you so much for taking the time to fill out this form. Once I've finished editing your precious little ones session I routinely post an image to Facebook on my business page, Chaunva LeCompte Photography. If you'd like to be able to tag yourself in your little ones image once it is posted please request me as a personal friend on facebook. My Facebook page is Chaunva Smith LeCompte. This is the only way Facebook will allow me to tag you! I look forward to seeing/meeting everyone. :)