Media Waiver Release
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Caregiver 1 First Name
Caregiver 1 Last Name
Caregiver 2 First Name
Caregiver 2 Last Name

By submitting this form, I hereby authorize Downriver Panthers to use my photo, video, and likeness for the purpose of promotion in news releases, photographs, video, audio, website, marketing and advertising for an indefinite period of time.

If I am under the age of 18 or with the cognitive/intellectual disability, my undersigned parent or legal guardian is executing this release on my behalf and agrees to be bound by its terms.

 


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