Wilson, North Carolina • By Appointment OnlySalon / Appointments / Consultations: 252-468-1243
CLIENT CONSENT

Photo & Media Release

Record whether Pazzion Stylez may publicly use identifiable photographs or videos connected with salon services.

CLIENT PHOTO & MEDIA RELEASE

Record your photo-use preference.

Every client may choose whether Pazzion Stylez may publicly use identifiable photos or videos. Declining photo use does not affect your ability to receive salon services.

Before you submit

This form records your permission choice for photographs and videos created in connection with Pazzion Stylez services.

  • Clients may consent to selected uses or decline public photo/video use. Declining does not affect salon services.
  • When consent is given, only the selected uses are authorized, together with separate choices about face visibility and name use.
  • For clients under 18, a parent or legal guardian must complete and sign the guardian section.
  • Clients may later request that future use stop. Previously published or distributed materials may not always be retractable.
  • Typing the required full name(s) documents the electronic signature and acknowledgment submitted with the release.

Do not enter Social Security numbers, payment card information, passwords, medical records, or other highly sensitive information.

1

Client information

Tell us who this release belongs to.

Required fields

2

Photo & video permission

Choose consent or decline, then specify any permitted uses.

Photo/video permission
If consenting, select allowed uses
May your face be visible?
May your name be used?
3

Age & guardian information

Guardian authorization is required for clients under 18.

Client age status
4

Signature & acknowledgment

Review your choices and sign electronically by typing your full name.

Type your full name to document your permission choice.

Online photo-release submission requires JavaScript and Cloudflare spam protection. If the online form is unavailable, call Salon / Appointments / Consultations at 252-468-1243 or email lterry22812@gmail.com before any client photos are used.

Your response is sent directly to Pazzion Stylez for recordkeeping. No email app is required. Photo & Media Release record version: 2026-08-25-v6.