Photo Release
Aug 28, 2026 11:48 PM
DATE:______________________
STUDENT’S NAME:__________________________________________________________________________________
PARENTS’ NAME:___________________________________________________________________________________
*Disclaimer: Due to legal requirements, the following document is a formal release of information for
photographs, videos, and/or any other type of media to be used in conjunction with Tina Stemmler and
Christina Stemmler’s business, Tapping with Tina’s Ballerinas. While photographs, videos, and/or any other type of media are intended for advertising and promotion services for our business, written permission must be given.
We greatly appreciate your understanding and willingness to help. We only wish to post dance videos and photos to our Facebook page, Instagram, Youtube page and our website in order to share their progress with you and your family. If you are only uncomfortable with one of these platforms, please make note of your concerns in the explain portion at the bottom.
I,______________________, legal guardian of _____________________________________________hereby freely and voluntarily grant Tapping with Tina’s Ballerinas, Tina Stemmler, and Christina Stemmler the irrevocable right and permission, in respect to the photographs, videos, and/or any other type of media taken of me or my child, to use, re-use, publish and re-publish, and otherwise reproduce, modify and display the same, in whole or part, individually or in conjunction with other photographs, videos, and/or any other type of media, and in conjunction with any other copyrighted matter, in any and all media now or hereafter known, for illustration, promotion, art, advertising and trade, or any other purpose whatsoever. I hereby release and discharge Tapping with Tina’s Ballerinas, and Directors Tina Stemmler and Christina Stemmler, from any and all claims and/or demands arising out of or in connection with the use of said photographs, videos, and/or any other type of media without limitation.
I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Missouri, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Missouri. In the event of any action or proceeding commenced with respect to this Release, such action or proceeding shall be commenced in the District Court of the State of Missouri. (Initials)__________
Yes, I AGREE with the contents of this release and have read the terms of this release form and fully understand.
(Initials)__________
No, I DO NOT AGREE with the contents of this release and have read the terms of this release form and fully understand.
(Initials)__________
Explain:___________________________________________________________________________________________
Signature:__________________________________________________________Date:______________
Print Name:_________________________________________________________Date:______________