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Verification & Consent
Previous Client
Name
(Required)
First
Last
Email
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Phone
(Required)
Age Verification
(Required)
I confirm that I am at least 18 years old.
I am under 18 and have obtained permission from a parent or guardian.
Guardian Name
First
Last
Phone
Email
Platform Authorization
Please indicate the platforms on which you consent to have your images or comments shared:
MMR Artistry Website
Facebook
Instagram
Other
Other
Media Release Statement
Terms and Conditions
(Required)
I, the undersigned, hereby grant MMR Artistry the right to use my images, videos, and any comments I have made during the services provided by MMR Artistry. This permission extends to all media formats and applications, including but not limited to MMR Artistry’s website and social media platforms.
I acknowledge and agree to the following:
Scope of Use: MMR Artistry may use my photographs, videos, and comments for promotional purposes, including advertising, marketing, and publicity.
Confidentiality: My identity will remain confidential unless I grant explicit permission for my name to be used alongside my images or comments.
No Compensation: I understand that I am not entitled to any compensation for the use of my images and that such use does not create any legal liability or obligation on the part of MMR Artistry.
Expiration of Consent: This consent is granted indefinitely unless I provide written notice to MMR Artistry requesting its revocation.
Revocation of Consent: I understand that I have the right to request the removal of my images or comments from further use by contacting mo@mmrartistry.com or 313 343 1084.
Acknowledgment of Participation: I acknowledge that my participation is voluntary, and I have the right to decide whether to allow MMR Artistry to use my images and comments.
I hereby consent to the use of my images, videos, and comments by MMR Artistry
Signature
(Required)