BGC Member Media Waiver (Opt Out) - Boys & Girls Clubs of Central Minnesota

Child's Full Name*

First Middle Last

Child's Current Grade*

Site*

Media Waiver (Opt Out)*

No, I do not give my permission for Boys & Girls Clubs of Central Minnesota to use photographs/video recordings of my child for marketing and promotional purposes.
Yes, I give my permission for Boys & Girls Clubs of Central Minnesota to use photographs/video recordings of my child for marketing and promotional purposes.

Important: Although the Boys & Girls Clubs of Central Minnesota will take reasonable steps to prevent members with restrictions from being photographed, we cannot guarantee that a member will not be photographed/videotaped as part of a large group event. Parents taking photos: We do not restrict parents/guardians/community from taking photos during large culminating events or events that take place outside the Boys & Girls Club in the community. We do not attempt to ensure that they are not taking photos/video recordings of members who have restrictions.

Parent/Guardian Name*

First Last

Parent/Guardian Email*

Parent/Guardian Mobile Phone*

Parent/Guardian comments or specifications: