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Media Release
Media Consent:

I, the undersigned, hereby consent to the use of my photograph or likeness in any publication, videotape, pamphlet or promotion by Highland Park Minor Softball or other agencies which are promoting or furthering the mission of Highland Park Minor Softball. I understand that I will not receive compensation or consideration from Highland Park Minot Softball or anyone else for the permission granted in this Consent nor for the actual publication or use of my photograph or likeness. By signing this Consent, I understand I am releasing Highland Park Minor Softball from any and all liability that may occur as a direct or indirect result of my photograph, the release of my identity, or the public relations materials, including but not limited to the use of any quotations.

Must be 19 years or older to give consent.

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Confirmation that the media release above was reviewed in details and that media consent is being given. *
Name of Person the Consent is Provided for *
Name of Releasor *
Phone Number of Releasor *
Email of Releasor *
Date *
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