Name *

First Name

Last Name

How do you plan to use these photographs?

Please select as many as apply

Photo album

Canvas or framed print for wall - single

Canvas or framed print for wall - collection or collage

Holiday cards/ birth announcements/ other stationery

Sharing on social media

Small framed prints for gifts or office display

Other

I'd like help selecting, designing, and/or ordering professionally printed items

I prefer to pay via: *

I have a Mighty Mites Gift Certificate!

Cash

Check (payable to Emma Leitch)

Bank transfer (BD$ Bank of Butterfield acct. # 20 006 060 815197 100)

Paypal or Google Wallet (payable to etleitch@gmail.com)

I hereby grant to Emma Leitch and Mighty Mites Photography the absolute and irrevocable right and unrestricted permission concerning any photographs that she has taken or may take of me and/or any or all of my family members named above, including my minor children, to use, reuse, publish, and republish the photographs in whole or in part, individually or in connection with other material, in any and all media now or hereafter known, including the internet, and for any purpose whatsoever, specifically including illustration, promotion, art, editorial, advertising, and trade, without restriction as to alteration. I release and discharge Emma Leitch and Mighty Mites Photography from any and all claims and demands that may arise out of or in connection with the use of the photographs, including without limitation any and all claims for libel or violation of any right of publicity or privacy. *

I agree