Blanket Lady Photo Release Form

The Blanket Lady
1729 Northfield Drive
Rochester Hills, MI 48309

By submitting this release form along with my photograph, I authorize MacKellar Associates and its subsidiary The Blanket Lady, the right to use, publish and reproduce the image(s) I submitted electronically.

I agree that MacKellar Associates may use such photograph(s) of and/or from me, with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.



Name:
Email:
Date:
Organization (if applicable):


Permission:

Just a reminder to email your photo to blanketlady@mackellar.com (include the category as well as your place of origin) by June 10th.



Please enter the following code into the box provided: