Click here for a Printable Version of the Photo Release Form
Northern Dutchess Boys Youth Lacrosse
Photo Release Form for Minors
I, being the parent or guardian of the child/children listed below, hereby consent that
photographs or videos taken of my child during the Lacrosse Season may be used as indicated below. I acknowledge that this media may be used even after my child is
no longer involved with Northern Dutchess Boys Youth Lacrosse.
These pictures and/or videos may be used on the ND Lacrosse Website, Team Photo Sharing Websites and in Local News Media.
I DO NOT give my consent to have photographs of my child/children used by Northern Dutchess Boys Youth Lacrosse.
Name of Player: Grade
Name of Player: Grade
Name of Player: Grade
Signature of Parent Date
Please sign and return this along with the Code of Conduct Form. This signature will be kept on file.