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Photo Release Form

 

I hereby grant permission to Central Dekalb Sports Association (CDSA) at Wade Walker Park in Dekalb County GA to use my or my child (s) photograph on its World Wide Web site or in other official CDSA\Wade Walker Park printed publications without further consideration, and I acknowledge CDSA’s right to crop or treat the photograph at its discretion. I also acknowledge that CDSA may choose not to use my photo at this time, but may do so at its own discretion at a later date.

 

I also understand that once my image is posted on CDSA\Wade Walker Park’s web site, the image can be downloaded by any computer user on the internet. Therefore, I agree to indemnify and hold harmless from any claims the following:

 

  • CDSA Board of Directors, at Wade Walker Park in Dekalb County GA
  • All Employees or Volunteers of CDSA at Wade Walker Park in Dekalb County GA
  • Dekalb County Georgia
  • State of Georgia

 

CDSA, reserves the right to discontinue use of photos without notice.

 

                        Parent/Guardian’s Name:    _____________________________________________

 

                                                Child Name:              _____________________________________________

 

                                                Child Name:              _____________________________________________

 

                                                Child Name:              _____________________________________________

 

                                Address:                                         _____________________________________________

 

                                                                                         _____________________________________________

 

                                Phone:                                            _____________________________________________

 

                                E-Mail:                                            _____________________________________________

 

                                Date:                                                _____________________________________________

 

                                Signature:                                      _____________________________________________