Youth Sports Publicity Consent Form
Please complete this form to provide consent for the use of your child's image or information in youth sports publicity materials.
Participant's Full Name
*
First Name
Last Name
Participant's Age
*
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Sport or Activity
*
Consent Statement
*
Date of Consent
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Signature
*
Submit Consent
Submit Consent
Should be Empty: