Photo Consent Form

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Your Name*

Your Mailing Address*

Phone*

Email*

Patient Information

Patient Registered Name*

Patient Barn Name*

Age*

Breed*

Color

Sex (Mare, Gelding, Stallion)

Patient Location/Stable Name

Accept Terms*

I hereby grant Iowa Equine permission to use any photographs or videos take of my pet, in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of Iowa Equine and will not be returned. I hereby authorize to edit, alter, copy, exhibit, publish or distribute photographs or videos for purposes of publicizing Iowa Equine. In addition, I waive any right to royalities or other compensation arising or related to the use of the photographs or videos. I hereby release rights to all claims, demands, and causes to action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of my estate have or may have by reason of this authorization. In accepting these terms, I give authorization to use my name and my pet's name as listed in this form.

I understand.

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Photo Consent Form

Patient Information

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