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Media Release Form

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Media Release Form

Gia’s Club is seeking approval to have photos of all event activities included on our Gia’s Club website. Gia’s Club will approve all photos that are used, and in keeping with the rules and guidelines for Internet publishing, no names will be used with the photos, and no personal phone numbers, or addresses will be allowed on the unsecure portion of the website.

Client / Guardian: Please fill out the portion below

I hereby authorize sign and grant to Gia’s Club the full rights and permission to use and publish onto the Gia’s Club website, any and all the photographs and electronic representations taken of any of my family members at any activity or event. No names, personal phone numbers or addresses will be used with photos. If I choose to revoke this permission I will submit the change and the photos of my family members will be removed within in three 3-4 business days.

OPTIONAL – IF YOU DO NOT WANT PICTURES POSTED, FILL IN BELOW

 

I understand the above stated guidelines and I request that there be no photo representations of my family members on Gia’s Club web site. If I am part of a group photo, I understand that in order to fulfill this request, any identifying parts of the photo will be blurred out. In addition I also understand that I may be asked to step out of a group photo.

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