Auburn Montessori School Picture Registration Form

PICTURE DAY IS TUESDAY, OCTOBER 5, 2021

First Name

Last Name

Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

Zip Code

Phone

Child(ren) to be Photographed

Age(s) of Child(ren) to be Photographed in same order of person(s) listed above

INSTRUCTIONS FOR THE PHOTOGRAPHER

Yes, I'd like my child(ren) photographed:

Individually Only
Together Only
Both Individually and Together

SPECIAL INSTRUCTIONS FOR THE PHOTOGRAPHER, if any

COVID DISCLOSURE

Jean Wozniak Photography practices all CDC recommended and mandated restrictions at the time of this event for preventing the spread of Covid-19. We appreciate your understanding in abiding by these measures for this event.

By taking part in this picture day, you assume all risks associated with potential spread or exposure. Jean Wozniak Photography & staff also agrees to waive any liability or claim against those attending picture day. We hold no liability for any spread of the virus.

Your child's participation means you acknowledge and agree to this disclosure.

IMAGE RELEASE

We may use your child's photograph as sample work. Let us know within a week after picture day if you prefer we do not. No notice will be understood as permission.

Signature

Agreed and accepted by Client individually and on behalf of Client's Party:

Date

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Thank you for registering for this event!

Thank you for your interest in the school pictures!

I'm excited to photograph your child/children.

If you have any questions along the way, please feel free to contact me.

Jean Wozniak, M.Photog., CPP, D.C.Ph.S.

jeanwozniak@comcast.net

(603) 289-2634

View Submission