Mentee Application 2021-2022

 I, blanks as the parent or guardian of blank , grant permission to Building Beyond the Walls Nonprofit Organization to use photographs and/or video taken of my child for promotional and educational materials including, but not limited to, the following: brochures, social media, videos, newsletters, magazines, internal publications and in print.

I hereby waive any right to inspect or approve, now or in the future, the finished photographs and/or printed or electronic matter that may be produced using the finished photographs, video, or printed or electronic matter that includes my child, likeness, image, and voice, wheter that use is known or unknown to me. I understand that neither Building Beyond the Walls Nonprofit Organization nor its representatives wil reproduce said photographs, interviews or likeness for any commerical value or receive monetary gain for use of any reproduction/broadcast of said photographs or likeness. I am also fully aware that I will not receive monetary compensation for my child's participation.

I further release and relieve Building Beyond the Walls Nonprofit Organization and its Board of Directors from any liabilities, known or unknown, arising from the use of this material.

I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing to Building Beyond the Walls Nonprofit Organization. I agree that my failure to raise any questions in writing in conjunction with the signing of this document will be interpreted as a free and knowledgeable acceptance of the terms of this release.

   I grant permission for use of my child's image in print, video and/or digital media.            

I understand that my child's image may be used or released by Building Beyond the Walls Nonprofit Organization without additional notification.

Student's Name
First Name   Last Name      Date      Signature