Photo Release Form

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Photo Release Form

Alpha Kappa Alpha Sorority, Incorporated First Sisters Outreach, Incorporated
Delta Omega Omega Chapter P.O. Box 2410
P. O. Box 2105 Pine Bluff, AR 71613
Pine Bluff, AR 71613

RELEASE OF PHOTOGRAPHY AND VIDEO

I hereby give permission for photographs/video to be taken for the purposes of public information and publicity. I understand that these images/videos may appear in Alpha Kappa Alpha Sorority, Incorporated, Delta Omega Omega Chapter and/or First Sisters Outreach, Incorporated’s reports, newsletters, brochures, and other publications as well as websites, social media, and other online communications.

I further understand that I am releasing any interest in these images/videos.

Debutante's First Name *

Debutante's Last Name *

Debutante's Signature *

By providing your initials you are submitting your electronic signature.

Participant's Parent/Guardian's Signature

(If Debutante is under 18) By providing your initials you are submitting your electronic signature.

Date *

YYYY

THIS FORM MUST BE SUBMITTED NO LATER THAN SEPTEMBER 23, 2019

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