PHOTO RELEASE FORM - Washington State Music Teachers Association

Permission for Photo Use

Permission for photographs to be used for WSMTA website or WSMTA promotional activity

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

The person named in the photograph is(Required)

18 years old or younger

Over 18 years old

Parent or Guardian's Name(Required)

First Last

Parent or Guardian's Email(Required)

Email(Required)

Event or occasion of the photo(s)

Please indicate the place or event or occasion at which the photo(s) was/were taken.

Do you give permission for photographs and/or videos of the above named minor at the event indicated above to be used on the WSMTA website and for WSMTA promotional or other purposes?(Required)

Yes

Do you give permission for photographs and/or videos of yourself at the event indicated to be used on the WSMTA website and for WSMTA promotional or other purposes?(Required)

Yes

Please include any comments or concerns

WSMTA Privacy Policy Acknowledgement

By checking this box, I confirm having read, understood, and accepted the WSMTA Privacy Policy.

Please contact [email protected] if you have any questions about this form.