Parent Release Form for Photography/Video

I, the undersigned, do hereby grant or deny permission to CrossFit Bytown to use the image of my child, Someone With A Long Name Goes Here, as marked by my selection below.

 I deny permission to use my child’s image in any way.

 I grant permission to use my child’s image in the following way:

xxx For Private Use ONLY: My child’s image (still photo or video) may be taken, but only shared privately (e.g. Email, Secured Cloud Drive, etc).

xxx For CrossFit Bytown Social Media: My child’s image (still photo or video) may be used for the above categories as well as being used for CrossFit Bytown social media accounts (website, instagram, etc). These images may be used without further notifying me.

xxx With Permission: Same as “For CrossFit Bytown Social Media”, but each image (still photo or video) must receive explicit permission (such as verbal permission, through text, or email)

Parent/guardian signature Someone With A Long Name Here Date June 15, 2019

If you have questions, please contact Andrew Forward at (613) 795-5273 or aforward@gmail.com.