Sports Broadcast Highlight Release Form

Sports Broadcast Highlight Release Form
Authorize the use of your image, video, or audio in sports broadcast highlights.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Role in Event
Organization or Team Name
Event Name
Event Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Event Location
Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you over 18 years of age or signing as a parent/guardian?
If signing as a parent/guardian, please provide your full name
First NameLast Name
Supporting Document (optional, e.g., team ID, accreditation)
Cancelof
Signature
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Date of Consent
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: