P4P Media Release Permission Form
Dear Parent/Guardian,

Below is a Media Release Permission Form for Perform 4 Purpose. You are receiving this form because your child is currently participating/has participated in a Perform 4 Purpose Program where photographs may be/have been taken of your child. Perform 4 Purpose requires your permission to use these photographs for promotional media purposes. Only photographs will be used for these purposes. Names or any other type of identifying information will not be used. If you have any questions regarding this Media Release Form, please feel free to contact your program facilitator.

Performer *
Your answer
By signing electronically below, I give permission to use any performance images, video, and still photos of the above mentioned individual in any Perform 4 Purpose promotional media without the use of my performer's name or any other identifying information. I give my permission for these images to be posted to the Perform 4 Purpose website, social media sites, and be shared with other web or print-based media outlets for the single purpose of promoting the mission of Perform 4 Purpose. *
Your answer
Date *
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