• Pucks with Purpose

    Photo and Media Release Form
  • Format: (000) 000-0000.
  • Photo and Media Release

  • I hereby grant Pucks with Purpose and its representatives, employees, volunteers, sponsors, partners, and authorized media permission to photograph, videotape, and/or record me (or my child) during programs, events, activities, and related functions.

    I understand that these photographs, videos, and recordings may be used without compensation for educational, promotional, fundraising, marketing, social media, website, newsletters, print materials, press releases, and other lawful purposes.

    I grant Pucks with Purpose the unrestricted right to use, reproduce, publish, edit, distribute, and display these images and recordings in any format or media now known or developed in the future.

  • I understand that

    • My name (or my child's name) may be used in connection with the images unless I request otherwise in writing.
    • I waive any right to inspect or approve the finished product in which my likeness appears.
    • I release and hold harmless Pucks with Purpose, its directors, officers, employees, volunteers, sponsors, and affiliates from any claims arising from the use of these images or recordings, including claims related to privacy, publicity, or copyright.
  • Opt-Out (Optional)

  • Pucks with Purpose

    Photo and media Release Form
  • Consent

  • I have read and understand this Photo and Media Release Form. I voluntarily agree to its terms.
  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • For Participants Under 18

  • I am the parent or legal guardian of the minor named above. I have read this Photo and Media
    Release Form and give permission for my child to be photographed, videotaped, and/or
    recorded by Pucks with Purpose for the purposes described above.
  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year
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  • Should be Empty: