Submit Form

Name *

First Name

Last Name

Date Of Shoot *

MM

DD

YYYY

Deposit *

I understand that the deposit paid to Jealous By Nature is NON REFUNDABLE. I understand that this covers Jealous By Nature's time and resources for seeking locations, administration costs and all other time consuming activities related to putting on events/photoshoots. Your deposit is transferrable in the event of any un for seen circumstances.

I AGREE TO THE ABOVE TERMS

Weather *

I understand that In the event of bad weather I must arrive at the shoot location where Jealous By Nature will make the judgement on whether or not we are safe to proceed. In the case that bad weather prevents us from completing the shoot Jealous By Nature will transfer your deposit to a shoot at a later date. If you do not arrive for the shoot you will lose your deposit. On rare occasions where the weather warnings have been issued Jealous By Nature may call off the shoot in advance and will reschedule your shoot.

I AGREE TO THE ABOVE TERMS

Injury Disclaimer *

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS EVENT with Jealous By Nature, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: JEALOUS BY NATURE (JBN) and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers; (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that Jealous By Nature and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I AGREE IT OF MY OWN FREE WILL.

I AGREE TO THE ABOVE TERMS

Photographic Consent *

I hereby consent and agree that Jealous By Nature has the right to take or use photographs of me (and/or my property) and to use these in any and all media worldwide including online, now or hereafter known, and for any purpose whatsoever. I hereby release to the Photographer all rights to exhibit this work in print and electronic form publicly or privately and to market copies. I waive any rights, claims or interest I may have to control the use of my identity or likeness in the photographs and agree that any uses described herein may be made without compensation or additional consideration of me. I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.

I AGREE TO THE ABOVE TERMS

I DO NOT GIVE PHOTOGRAPHIC CONSENT

Use of Images *

I understand that the images provided are for personal use only and I must gain written consent from Jealous By Nature to use any of the images for commercial purposes.

I AGREE TO THE ABOVE TERMS

Age Disclaimer *

I declare that I am 18 years old or above, or, that I am 14-18 years old and have sought my parent’s/guardian’s consent in my participation in activities as signed by my parent/guardian.

I AGREE TO THE ABOVE TERMS

Medical Disclaimer *

I confirm that there are no health or medical reasons, to the best of my knowledge, that would prevent me from taking part in the activities associated with the photoshoot, including but not limited to pregnancy, heart problems & recent surgeries.

I AGREE WITH THE ABOVE TERMS