S4TK RELEASE FORM
Liability, Photograph, Video, and Social Media Consent
SPORTS 4 THE KIDS
For and in consideration of benefits to be derived from the further promotion and development of the recreational programs provided by Sports 4 the Kids, Inc. (I), (We), the undersigned parent(s) or legal guardian(s) of (First Name of Athlete): *
Your answer
Last Name of Athlete (not used on Social Media) *
Your answer
a student entered in the Seminole County Public School system, for our child above named and for ourselves, do hereby consent, authorize, and grant permission to the Sports 4 the Kids, Inc., its agents, employees, volunteers, or duly authorized representatives to take photographs, motion pictures, or video tapes of the undersigned for ourselves and said student, and do further consent to the publication, circulation, and dissemination of said photographs, motion pictures, or video tapes, or any duplication or facsimile thereof for any purpose it may deem proper. In granting such permission, (I), (We) hereby relinquish and give to Sports 4 the Kids, Inc. all right, title, and interest (I), (We) may have in the finished pictures, negatives, reproductions, or copies, and, for ourselves and our minor child, and further waive any and all right to approve the use of such photographs, motion pictures, or video tapes and further do waive any right to compensation for the publication or other use of said photographs, motion pictures, or video tapes and do release Sports 4 The Kids, Inc. its agents, licensees, representatives, and assigns from any and all liability claims of any nature whatsoever from their use. It is also understood that Sports 4 the Kids agents, employees, and volunteers will not be held liable for any injuries that may occur from your child’s participation. First Name Parent/Guardian: *
Your answer
Last Name Parent/Guardian: *
Your answer
Email Address
Your answer
Coach's Name
Your answer
What is the sport of interest? *
Date of Release: *
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