Free photo release form 47
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PHOTO RELEASE FORM

MINOR CHILD’S NAME _____________________________________________________________
PARENT(S) ________________________________________________________________________
ADDRESS _________________________________________________________________________
PHONE ___________________________________ OR ____________________________________
EMAIL ____________________________________________________________________________

_______ I DO give permission for my child’s picture to be used by the Rye Youth Council on
their website or any other publication in conjunction with Rye Youth Council programs, with the
understanding that his/her name will not be used with the photo nor will he/she be identified in
any other way.
_______ I DO NOT give permission for my child’s picture to be used by the Rye Youth Council.

_________________________________________________________________________________
Parent/Legal Guardian Name (print)

_________________________________________________________