Photo Submission Permission

1. Name *

First

Last

2. Email *

3. Phone *

4. Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

5. I give Nicole Gayle and her affiliates full permission to use my photograph on any platform, written, digital, video or website. I also agree that my photo will be used in the diamond radiance video trailer and may also be used for promotional purposes with full integrity. I understand that Nicole Gayle and her affiliates will never misrepresent my photo. *

6. Today's Date *

Questions/Concerns? Please contact Nicole at: [email protected]