Consent Form

- for underwater photography -

To arrange a photography session for your swim school, a private photography swimming session or discuss prices, or to ask any questions please contact me.

Full Name of Child

Name of Parent / Guardian

Email Address

Postal Address

Contact Phone Number

Landline

Mobile

Swimming Class

Day

Date

Time

Location

Are you the child’s parent or guardian?

Do you give consent for Underwater Portraits By Amy to photograph you and your child?

Do you give consent for Underwater Portraits By Amy, Pregnancy Portraits By Amy and the swim school to use the photographic images for publicity purposes, in publications on social media & on their websites?

Are you happy for your child’s images to appear on the online gallery next to others in the class?

Please write a description of yourself and your child and what you are wearing in the pool for identification purposes.

Declaration

I confirm that the above named wish to participate in the services organised by Underwater Portraits By Amy. I declare that if I am not the parent or guardian of these children that I have authority to sign this disclaimer.

I confirm that I do not know of any medical condition that I or my child has, that might make it more likely to be involved in an incident which could result in injury to myself or others.

I understand that I am responsible for my possessions, my own safety and the safety of the child under my care.

I understand that the service will be carried out without direct supervision and in the unlikely event of an accident involving myself or the child in my care, or any loss or damage to our personal effects, I acknowledge that the swim school, Underwater Portraits By Amy or Pregnancy Portraits By Amy will not be liable for any direct or indirect loss, damage or injury arising from or in connection with the service. I agree to waiver claims against the mentioned companies in this respect, in respect of myself and the child/children in my care.

I acknowledge and confirm that I have read and understood the company’s Terms and Conditions, and disclaimer and I accept these terms contained therein.

Your Signature