Photo Release Form

Photo Release Form

New Gateways Facebook Page,Classroom DoJo, Advocacy Purposes
I hereby consent that New Gateways, Inc. and their affiliates may use the photographs taken of my participant. Furthermore, I hereby consent that such photographs shall be their property and that they should have the right to publish and make other uses of such photographs that they may desire free and clear of any claim whatsoever on my part.

I also understand that photographs taken of my participant are to be used specifically for the purpose stated below. By signing the document, I give permission for the image to be used specifically for those purposes.

Purpose of Consent: Classroom DoJo, New Gateways Facebook Page, Advocacy Purposes such as the Detroit News
Consent

I hereby grant and authorize New Gateways to make use of photos involving my program participantI do not allow the use of the photos taken involving my program participant
Name of Participant

First NameLast Name
Name of Parent/Guardian

First NameLast Name
Signature of Parent/Guardian

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Date Signed

MonthDayYear
Date
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