Name *

First Name

Last Name

Phone *

(###)

###

####

Today's Date *

MM

DD

YYYY

Which pictures may be used? *

Any of my images, but with my face cropped out for privacy

Any detail shots that do not include my face

Certain image that I will okay with the photographer beforehand

Any of my final images

None - Please do not use any of my images

When can your images be used? *

Immediately

Do not use my images

After the date I provide directly to the photographer

Can your story be summarized in my own words (Katrina's) in a blog to be posted on the Body Issues website and/or Body Issues' social media accounts? *

Yes

No

I agree to credit Body Issues, LLC/@body.issues.photography whenever I use the photos from this photoshoot. *

Yes