Your Stanley Sessions Submission

Have you been affected by suicide in any way? Share your experience below:

Name *
Name
Choose a Session Date (Saturdays ONLY)! *
Choose a Session Date (Saturdays ONLY)!
To the best of your ability, please select a Saturday that works for you to come in for your photography session.
Choose a Session Time! *
Choose a Session Time!
To the best of your ability, please select a general time that works for you to come in for your photography session. Normally, our hours run from 10:00am - 2:00pm.
I would like my photo and story to appear in: *
Phone *
Phone
Photo Release Agreement *
For valuable consideration received, I grant to Whitney Saleski ("Photographer") the absolute right and unrestricted permission concerning any photographs that she has taken or may take of me or in which I may be included with others, 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; and to use my name in connection with any use she so chooses. Photographer retains this absolute right, but upon client's request, all images and stories can be removed. At any time, the client can request that the images and stories be taken down. I do understand that once the images and stories are shared on social media, Photographer only has the power to retract from the website, Facebook, and/or Instagram of the Stanley Sessions. I release and discharge Photographer 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. This authorization and release shall also inure to the benefit of the heirs, legal representatives, licensees, and assigns of Photographer, as well as the person(s) for whom she took the photographs. I also acknowledge that, due to the influx of submissions, my photograph and/or story may not be selected for the final product or any other materials resulting from said product. If my photograph and story are selected, I agree to the aforementioned text. I am a legally competent adult and have the right to contract in my own name. I have read this document and fully understand its contents. This release shall be binding upon me and my heirs, legal representatives, and assigns. I agree to allow my photos and story to be shared.
I agree to arrive at the following address on my scheduled day and time: NAMI of Montgomery County, 409 East Monument Avenue, Suite 102, Dayton, OH 45402: *
I understand that Stanley Sessions does NOT accept walk-ins or unscheduled appointments; the Stanley Sessions is NOT a faith-based project; and that I CAN be listed as "Anonymous" in my portrait and/or story: *