SASA Midland District
Refusal of Photography
Full Name
*
First Name
Last Name
Contact Email
*
example@example.com
Club
*
Event
*
Please Select
Midland District Sept Sprints 2024
SASA Number
*
I refuse permission for the Official Photographer of SASA Midland District and its media partners to take and/or publish the images of me / my child. This includes the sharing of photos/images on your website and social media sites.
*
Print Name
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First Name
Last Name
Date
*
-
Day
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Month
Year
Date
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