grettie's goodies Waiver and Media Release Form

Name of Baker (Student, Camper, Counselor or Party Attendee)

Birthdate

Date

Name of Person Completing Form

First and Last Name

Relationship to Baker (Student, Camper, Counselor or Party Attendee)

List any food allergies, food sensitivities, behavioral or medical concerns we should know about

For Youth Bakers, list adults or siblings approved for pick up: Please list name, relationship and phone number

For Youth Baker, can they sign themselves out?

If Yes is Selected

I grant permission to grettie's goodies, to use my or my child's media (photograph image and/or video footage and/or audio recordings). I approve the use for only those media options I have selected above.

I likewise understand that I or they may be identifiable from the reproduction of the media by grettie's goodies indicated herein this agreement.

I hereby waive my rights to inspect or approve the media for production that may be used by grettie's goodies for purposes stated herein, from hereon forward.

I likewise waive any right to royalties or any compensation arising from or related to the use of the image.

If No is Selected

I do not grant permission to grettie's goodies, to use my or my child's media (photograph image and/or video footage and/or audio recordings) for any reason.

I give consent for grettie's goodies to use photographs and videos taken in her classes, camps or parties for marketing purposes

YesNo

Email

example@example.com

Phone Number

The Media obtained can be used for