Paul Blodgett Goalkeeper Training School Camp Form

Parental Authorization and Release – Photography and Videotaped

Name of Child: ____________________________________
Age: ________

Name of Parent or Guardian:

____________________________________
Please Check One:
______
Yes, my child may be photographed or videotaped
______
No, my child may not be photographed or videotaped
Signature of Parent or Guardian: ____________________________________
Date: __________________