PHAME Academy has my permission (during class and/or performances) to use my
likeness, name, voice, or words in either newsletter articles, television,
radio, film, newspapers, and other media, and in any form, for the purpose of
advertising or communicating the purposes and activities of PHAME Academy and/or
applying for funds to support these purposes and activities.
I have read this information and fully understand that by signing the form on the
student registration page, I am saying that I agree to its terms.
Release should be signed by a witness to the student's understanding of this
release form.
I hereby certify that I have reviewed this release with the student whose signature appears
above.
I am satisfied based on that review that the student understands this release and
agrees to its terms. (Enter your name on student registration page)
Relationship to student (family member, personal agent, teacher, etc.)
Release to be completed by parent or guardian of MINOR student.
In permitting the student to participate, I am specifically granting my
permission (during class and/or performances) to PHAME Academy to use the
student’s likeness, name, voice, or words in either newsletter
articles, television, radio, film, newspapers, and other media, and in any form,
for the purpose of advertising or communicating the purposes and activities
of PHAME Academy and/or applying for funds to support these purposes and activities.
Through my signature on the student registration form, I am agreeing to its terms.