Consent And Media Release Form (Page 2 of 2) in pdf

Consent And Media Release Form Page 2

Full Name of Adult Student

Participant or Depicted Person: _____________________________________________________

Signature of Adult Student

Participant or Depicted Person: _____________________________________________________

Date: ____________________________

Full Name of Minor Student

Participant or Depicted Person: _____________________________________________________

Full Name of Parent/Legal Guardian

of Student Participant or Depicted Person: ____________________________________________

Signature of Parent/Legal Guardian

of Student Participant or Depicted Person: ____________________________________________

Telephone Number of Parent/Legal Guardian

of Student Participant or Depicted Person: ____________________________________________

Email Address of Parent/Legal Guardian

of Student Participant or Depicted Person: ____________________________________________

Date: ____________________________

Submission Instructions:

Please review the time limitations for the Consent and Release Form submission in the Official Contest Rules. All

Submissions must be accompanied by a signed Consent and Release Form(s) on behalf of any and all Student

Participant(s) and Depicted Person(s) and submitted by an adult representative of the school entering the Contest

(the “School Entrant”) via email to . Additional instructions for entering

Submissions, including video Submissions, may be found in the Official Contest Rules.

Consent And Media Release Form Page 2