Your Name *

First Name

Last Name

Child's Name *

(If registering more than one child, please include their names, and their class, in the "note" section below)

First Name

Last Name

Phone

(###)

###

####

Shipping Address *

Where should we mail your photographs?

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Model Release *

Our small business relies on the ability to share and showcase our work, that being said we very much respect parental rights and whatever decision is best for your family. Please answer "yes" or "no" to the following statement. Mary Brunst Photography has permission to use my child's photo in their promotional material, including their website, Facebook & Instagram pages, and print material. Mary Brunst Photography agrees to never use any image to exploit, embarrass, or reflect negatively in any way on any individual photographed.

Yes

No