Photo & Video Release Consent
For Revere Lions Soccer Club – Parent/Guardian authorization for use of child’s photos and videos.
Parent/Guardian Full Name
*
First Name
Last Name
Player Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Consent for Use of Photos and Videos
*
I grant permission for Revere Lions Soccer Club to use my child’s photos and videos as described below.
I do NOT grant permission for Revere Lions Soccer Club to use my child’s photos and videos.
Select the specific uses you allow (if granting permission):
Club website
Social media
Printed materials
Internal club use
Advertising/promotional purposes
Please indicate if you allow your child’s name to be used with images/videos:
*
Yes, my child’s name may be used with images/videos.
No, please do not use my child’s name with any images/videos.
IMPORTANT:
There is no compensation for the use of photos or videos. Consent may be revoked at any time in writing to the club. Images and videos may be used without names unless explicit consent is given above.
Parent/Guardian Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Consent
Submit Consent
Should be Empty: