BUSYBODIES DANCE COMPANY, INC.
SOCIAL MEDIA AGREEMENT 2020-21
Name of Dancer:
Age of Dancer:
Dancer's Date of Birth:
Parent's Phone #:
Street Address Line 2
State / Province
Postal / Zip Code
Authorization, Release, and Consent
I hereby grant permission to BusyBodies Dance Company, Inc., its employees, affiliates, and representatives,
the right to photograph, televise, film, and sound record and to use these photographs/digital images, video/audio recordings and utterances or quoted remarks of my child for the use in educational and presentation materials, and/or promotional materials. These may include printed or electronic publications, websites, social media, or other electronic communications.
I agree that my name and identity may be revealed by BusyBodies Dance Company in descriptive text or commentary in connection with printed and video images.
I authorize the use of materials stated above without limit as to time to produce and reproduce the same of any part thereof by any method, and to use for any purpose which BusyBodies Dance Company, Inc. deems proper and with no payment or compensation to me.
I agree that all negative and positive prints, digital reproductions, video and audio recordings shall be the property of BusyBodies Dance Company, Inc.
To express my understanding of, and agreement to, this release, I affix my signature hereto:
Should be Empty: