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Photo/Video Release
Photo/Video Release
SOServices
2023-01-13T11:23:54-06:00
Photo/Video Release Form
I grant Rice Lake Aquatics and Recreation Center my permission to use photographs and/or videos for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, social media and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
Name of Participant
(Required)
First
Last
Is this Photo/Video Release for a minor child?
(Required)
Yes, this release is for a minor child
No, this release is NOT for a minor child
Consent
(Required)
CONSENT: We/I hereby certify that We/I are/am the parent(s) or guardian(s) of the above named child and do hereby give our/my consent without reservation to the foregoing on behalf of My Child.
Name of Parent/Guardian
(Required)
First
Last
Consent
(Required)
CONSENT: I represent that I am at least eighteen (18) years of age, and give my consent without reservation.
Date
(Required)
MM slash DD slash YYYY
Signature
(Required)
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P.O. Box 387,
Rice Lake, WI 54868
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