Ethereal Birth Photography - Model Release Agreement

By voluntarily participating in a photography session organized by Jordan Tomkinson D.B.A. Ethereal Birth Photography, and digitally signing the consent form below, I am consenting to have my photos taken by Ethereal Birth Photography, and agree with the Payment Policy and Deposit & Refund Policy.

I consent to allow photos to be used for her personal, promotional, and commercial purposes on any business websites, portfolios, and/or social media accounts that she operates, for personal and/or professional purposes, without financial compensation for the use of my likeness or the likenesses of other guests invited to attend the session with me, and I agree that Jordan retains full creative control over the production of her images.

I agree that she shall retain full and exclusive ownership and copyright of the images she produces, and that I am satisfied to only have a license to use these images for personal use, unless otherwise negotiated and agreed upon in writing.

I agree to conduct myself with reasonable professional courtesy and respect, and harassment or disrespect of any kind to any party involved in our photoshoot may result in the immediate termination of this agreement, termination of the session, and the loss of access to any images I have appeared in, without a refund of any fees I was charged in exchange for her services, or any other compensation.

I agree that, should any litigation between parties become necessary to resolve a dispute, it shall be litigated through arbitration in the state of Utah.

I agree that by digitally signing this consent form, I fully understand the terms of this agreement, any questions or concerns have been addressed verbally or in writing, and I am choosing to proceed with booking this photography session.

PAYMENT POLICY

If your balance is not paid in full before your birth, your full digital album will be withheld until your balance is paid.

Those first few weeks are always a complete blur, and I don’t want to be a source of stress for you while you’re bonding with your baby. I know what it’s like to have a little one on the way, and a mile long list of things you need to spend buckets of money on before they get here.

For the sake of your postpartum peace, if it’s possible to pay before your birth, I recommend it, so there’s one less person trying to hound you for money while you’re busy recovering and snuggling your little one and getting the hang of breastfeeding.

My website offers Klarna through the checkout page, and PayPal also offers Pay It In 4 payment plans. I am on both Venmo and PayPal. My username is @etherealbirth. QR codes below:

DEPOSIT & REFUND POLICY

80% of your total payment is a NON-REFUNDABLE deposit to book my services.

Cancellations within 14 days of entering the above service agreement will be returned for a full refund as soon as possible.

I make myself unavailable to other clients so I am on call for you - whether I attend your birth or not, my lifestyle is significantly impacted by being on call for you around the clock from 39 weeks to 42 weeks.

To keep my schedule manageable and prevent myself from accruing a significant backlog to edit, while I’m also attending clinic appointments and births as a Student Midwife, I can only accept a maximum of 3 clients per month. This means the sustainability of my business is heavily reliant on clients following through.Thank you for your understanding!

Your Name

First Name

Last Name

Cell Phone Number

I need to add you to my contacts and enable Emergency Bypass, so my phone will ring when you text or call at 3am, and your call won't be auto-forwarded to voicemail.

(###)

###

####

Emergency Alternate Phone Number

Just in case your phone dies but I still need your room number and access code, or get lost in the dark in your neighborhood at 3am.

(###)

###

####

Estimated Due Date

This helps me manage my schedule, so I can be prepared and on-call starting at 38 weeks.

YYYY

Your Email Address

I'll send your finished album via Google Drive. It will be available for a minimum of 30 days for you to download digital versions.

Your Home Address

In case the birth is going quicker than expected and you won't make it to your hospital or birth center.

Your Birth Location Address

Example: "Utah Birth Suites, 1883 N 1120 W, Provo UT 84604" I will save this address to your contact information.

Who will be present at your birth?

Please include names and roles.

Do you have any specific modesty preferences?

If you'd be MORTIFIED if your un-blurred nipple was included in a photo of the moment you first brought your baby to your chest, please be very specific about what your hard boundaries are.

Social Media Privacy Preferences

While I retain ownership of all images I capture, and retain the right to share the uncensored images of you and your baby's faces on my website portfolio, I want to respect your Social Media preferences if you have concerns about data privacy on platforms such as Instagram and Facebook. Please check each box below to approve me sharing specific types of identifying information, including you and/or baby's faces, when I post images on my social media. If ONLY the last box is checked, I may still share uncensored images from your birth here on my website that I would not share on social media. I will do my best to do so in a way that would be pretty much impossible for anyone to identify you, such as posting the album under a false name in my portfolio months later with a falsely tagged location.

You can share my first name

You can share my uncensored face

You can tag my social media username

You can share my baby's first name

You can share my baby's uncensored face

You can share the names and faces of other loved ones present

Fake names and cropped out/obscured faces only

Other Birth Professional Release: Are you comfortable with images featuring you and/or your baby being included in your midwife, doula, or other birth practitioner's social media, portfolio on their website, etc?

(Most often applicable to doula and midwifery clients delivering at a birth center.) If you have formed a close bond with your provider and are comfortable with me sharing your birth details and photos with them, please share their name and contact information here. Type "not applicable" if you are delivering with an OBGYN in a hospital.

If you answered yes to the questions about your privacy, are there any people I should know about who I need to block for your safety/peace of mind?

If you're No Contact with a toxic family member, have a restraining order against an ex, have a stalker I should know about, etc, this is VERY important so I can keep you safe.

Are there specific things you do or don't want to see in your finished private album?

If you're grossed out by blood, a placenta, meconium, bath water with amniotic fluid/blood/vernix/meconium in it, needles, your baby crowning, etc, please be VERY specific about if you wish for those images to be excluded entirely, edited to be black and white only, blurred or cropped out, etc.

Should I continue taking photos and recordings if things get upsetting, traumatic, or become an emergency?

What if we have to transfer your baby to Primary Children's Hospital, or you aren't doing very well and need an emergency c-section? Having photos and videos of the hard things may actually help you to process birth trauma later when you're ready for it. Photos and videos can also be excellent documentation with timestamps, dosages, and things of that nature that your providers could also reference if they must peer review as a result of a complication or negative outcome. In such a scenario, I'll keep these photos in a separate folder labeled clearly as TENTATIVE BIRTH TRAUMA, so you can view your birth album without being exposed to the more upsetting moments. NOTE: I'm a Certified Advanced Provider for the Neonatal Resuscitation Program. If your midwife needs me to put the camera down to participate in a resuscitation, I am required to do so.

NON-GUARANTEE CLAUSE E-SIGNATURE

I will do my best to make arrangements with my husband and children, and to arrive in a timely fashion, but I CANNOT GUARANTEE that I'll make it to your birth, especially if I'm given less than 3 HOURS NOTICE that labor has begun. I need your cooperation to stay in communication with signs of early labor, or arrangements for an induction/c-section! Failure to notify me of your birth does not mean you will get a full refund - see refund and deposit policy above for an in-depth explanation. If I am not able to attend your birth due to extenuating circumstances like weather, traffic, chronic migraines, etc, I will do my best to make arrangements with you for Fresh 48 photography or a family photography session at a later date. Please write your full legal name in the field below as a digital signature to affirm you agree with Ethereal Birth Photography's full terms.

Ethereal Birth Photography - Model Release Agreement

PAYMENT POLICY

DEPOSIT & REFUND POLICY

Jordan Leigh TomkinsonUtah County Birth Photographer, Doula, & Student Midwifejordan@etherealbirth.com

Jordan Leigh Tomkinson
Utah County Birth Photographer, Doula, & Student Midwife
jordan@etherealbirth.com