Alex Neely, Photographer
Holiday Pet Portraits at Dog City Bakery Marietta
Benefiting Atlanta Boxer Rescue
Nov. 3, 2019


Name: First _______________________________ Last_____________________________________
Email Address:______________________________________________________________________
Phone:__________________________________ Number of Pets Being Photographed: ___________
Pet (and or human) Name: Pet Color & Breed:
_______________________________________ _________________________________________
_______________________________________ _________________________________________
_______________________________________ _________________________________________
_______________________________________ _________________________________________
Donation Amount: $______________ Received by: ______________________________________

In return for photographic services - including providing a setting and the acts of
photographing, digitally processing and placing images on a website for my review and
consideration for purchase - provided by Alex Neely (“Photographer”) I, (PRINT NAME)
_______________________________________________, give permission for
photographs taken by Photographer at Dog City Bakery, Marietta, GA on November 3, 2019
(“Event Photos”) in which I or any member of my family may appear to be placed on
Photographer's website for the purpose of my review and purchase of images, prints or products
created from Event Photos. I further give Photographer permission to use Event Photos in
which I or any member of my family may appear for the purpose of promoting Photographer's
business activities and Atlanta Boxer Rescue's fundraising activities. I understand that I am not
obligated to purchase prints, downloads, or products created from Event Photos. I
acknowledge that I am donating the amount specified in “Donation Amount” on this form, in
lieu of a sitting fee, to Atlanta Boxer Rescue to help pets in need. I understand that the donation
is for the sitting and does not include prints, products or downloads of Event Photos. I am of
the legal age to sign this RELEASE; I am the parent or legal guardian of any minors appearing
in Event Photos.

Please add me to: Photographer's mailing list (init.)_______, ABR mailing list: (init.)_______.
Signed: _____________________________________________ Date:____________________
Witness: ____________________________________________ Date: ____________________
Time form filled out: _________________________