Photo Release Form - Community League
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1Name of your league
Photo Release Form
__________________________________________
Community League
[insert date]
I confirm that I am over *18 years of age and I consent to the use of my name, portrait,
picture or photograph being used by the _________________________ community league.
I understand that this material may be used for future promotions, advertisement, social
media, presentations and/or video and in other media forms and will be made available online
at
__league website
URL________ in print format/video/other, as applicable.
I agree that I shall have no claim against ___________________ Community League, its
membership or against anyone accessing this communications product, whether online, in
print or by any other means.
*If under the age of 18, a parent or guardian must sign consent form.
Signed,
________________________________________ Age: ____________________
Name (please print): _______________________________________________
Date: ___________________________________
Parent or Guardian if applicable
Signed by: __________________________________________ for
Dependant’s name (please print): ________________________________ Age: _____
Parent or Guardian Name (please print): ____________________________________
Parent or Guardian contact information (email & phone): _____________________________
Date: ___________________________________
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