I love to share pictures of my doula families on my website and in my educational materials that I give to new clients. I will only use photographs I have releases for so if you are comfortable with sharing your lovely family with us, please fill this out.

I/we the undersigned, do hereby give my/our consent and authorize and permit Sabrina Roberson, dba Moon Cycle Arts, to use or permit other persons to use the negatives, photographic prints, digital images, slides and/or video prepared there-from for such purposes and in any such manner (i.e. world-wide rights, in magazines, books, journals, websites, public presentations, photo albums) as she or they may choose without any compensation or recognition of any kind to those photographed. The negatives, photographic prints, slides, video and/or digital images are the sole property of Sabrina Roberson, photographer. Any exceptions to this release are specifically listed below:

Exceptions ________________________________________________________________________________

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Name (please print) ____________________________________________________ Date ________________

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