Media Release Form

We would appreciate it if parents completed this consent form in order to allow their children to be photographed during special events or normal day-to-day activities organized by the Little Miss Black Joliet Pageant.

If you do not want to have your child photographed/News interviews, recordings, etc. published, please do not hesitate to indicate this in the section below by leaving the corresponding checkbox(es) empty.

As the parent of a child in the Little Miss Black Joliet Pageant, I agree to the following:*

I understand that my child my be photographed by the media for Little Miss Black Joliet for activities, interview, recordings, photographs surrounding the pageant.I understand that these publications may be used or displayed on the Little Miss Black Joliet Pageant website, social media outlets and newspapers.I give permission for my child’s photographs to be shown on all Little Miss Black Joliet Pageant platforms, Website, Facebook page, YouTube, Instagram, newsletters, emails, newspapers or any other publication.

Child’s Name*

Parent/Guardian Name*

Date*

Date

Parent/Guardian Signature*