Permission to Use Image and Likeness

I hereby grant permission to (“Organization”) to use my image and likeness as captured through photograph, digital image, or video.

Full Name Email Address Address Description of Use (optional) I understand and agree that these materials may be used in print or digital media, including but not limited to websites, social media, promotional materials, and publications. I waive any right to inspect or approve the finished product in which my likeness appears.

Signature

Date

Parent/Guardian Name (if under 18) Required if participant is under 18 years old

Parent/Guardian Signature