Photo Release Form
Photo Release Form
I ______________________________________________________________________,
(Full name of parent or guardian)
of ____________________________________________________________________, ______ _____
( address, city and state ) ( parent or guardian)
the parent guardian of ________________________________________________________,
(Athletes full name)
hereby give my permission to Gold Rush Athletic Club, to use photographs of the above listed
minor in any publication, media release, promotional announcement or advertisement, electronic or otherwise. I agree that neither the above listed minor, nor I, will receive any compensation if such image appears in such publication, media release, promotional announcement or advertisement, electronic or otherwise. I understand that such image is the property of Gold Rush Athletic Club. In addition, I
understand that Gold Rush Athletic Club may supply such images to, or for the use and publication by, a corporate sponsor or licensee of Gold Rush Athletic Club in or for any commercial venture or advertisement, without my permission, if the use or publication is directly related to or in support of Gold Rush Athletic Club..
_______________________________________________ ______________________
(Signature) (Date)