Alpha Media Release

Alpha Media Release

2022 Oratorical Contest
Student Name*

First NameLast Name
Student Email*

Confirmation Emailexample@example.com
Student Phone*
Please enter a valid phone number.
The student is

Younger than 1818 or older
Age Consent*
Please Consent The Students Age
Granting permission for {studentName}
Parent:
This section must be completed by the parent or guardain only, this release will be confirmed by the committee.
Parent Name

First NameLast Name
Parent Email

Confirmation Emailexample@example.com
Parent Phone
No Dashes or Spaces Allowed
I, undersigned, agree with the selected statement:

I grant permission the student to participate and appear in video or audio recording, films, photographs, written articles, or on websites and social media sites.I do not consent to use of the student's photograph, voice, and/or name in various media projects.
Date

MonthDayYear
Date
Parent Signature

Clear
Student Signature

Clear
Should be Empty: