2026 Live the Dream : Youth Excursion Historic Immersion

2026 Live the Dream : Youth Excursion Historic Immersion

I hear by grant permission for my child to attend the Live the Dream: Youth Excursion | Historic Immersion June 26, 2026. This event will be held at the Augustus B. Turnbull Confrence Center in Tallahassee, FL. Photos/videos taken by the Florida Civil Rights Museum, Inc. at this signature event will be used for program development and marketing purposes. By signing below, the undersigned parent or legal guardian hereby grants The FCRM and its representatives the irrevocable right and permission to photograph, record, or otherwise capture the minor’s likeness in any media, and to use, reproduce, publish, display, and distribute such images or recordings for lawful promotional, educational, or informational purposes. Participants will not receive renumeration. ( Payment ) for their participation or the future use of images ,media created from the event.
Participant Full Name

First NameLast Name
Parent/Guardian Full Name (if participant is a minor)

First NameLast Name
Participant Email
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Parent/ Guardian Contact Email
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Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/ Guardian Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I hereby give permission for photos and/or videos to be taken of me/my child by the Florida Civil Rights Museum, Inc. during the event 'Live the Dream: Youth Excursion | Historical Immersion.
Signature of Participant or Parent/Guardian
Date

MonthDayYear
Date
Location
555 W Pensacola St, Tallahassee, FL 32306
The Florida Civil Rights Museum, Inc.

Co-Executive Directors:
Jacqueline Y. Perkins
Delaitre Hollinger

P.O. Box 6197
Tallahassee, FL 32314

A public charitable 501(c)(3) nonprofit organization.

Email: floridacivilrightsmuseum@gmail.com

Website: floridacivilrightsmuseum.org

For more information contact:
Kristen L. Mathis
(850)848-7632
Facilitator for Youth Engagement
Florida Civil Rights Museum, Inc.
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