We Rock the Spectrum – Adelaide and Christies Beach Parent/Carer Photo & Video Release Form
We occasionally post photos of our clients on our Instagram and Facebook page, to showcase our facilities and services. On some occasions we may include your child's first name only. Are you ok for your child's image and name to be posted?
Yes
No
Parent / Guardian Full Name:
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Participant (Child's) Name
*
First Name
Last Name
Parent / Guardian signed,
Date Signed:
-
Month
-
Day
Year
Date
Submit
Should be Empty: