Rec Woo Photo & Video Release Form

I hereby give my permission for the City of Worcester's Division of Youth Opportunities to use the pictures and/or videos, which I have willingly submitted to them. I hereby grant permission to the City of Worcester's Division of Youth Opportunities to use these videos and photos in publicity and marketing materials as well as on Division of Youth Opportunities social media sites (Facebook, Instagram, etc.).

Parent/Guardian Info

*Do you give permission as described above?

Yes No

*First Name

*Last Name

*Email

*Cell Phone Number
Example: 5085551234

Child(ren) Info

Please include information for all children who will be participating. If you wish to include more than four children, submit a new form for additional children.

*Child 1 First Name

*Child 1 Last Name

Child 2 First Name

Child 2 Last Name

Child 3 First Name

Child 3 Last Name

Child 4 First Name

Child 4 Last Name

Social Media Info

Please list any Instagram User Name(s) associated with your submissions:

Please list any Facebook User Name(s) associated with your submissions:

Please hit the "Send!" button below only ONCE.

Rec Woo Photo & Video Release Form

Parent/Guardian Info

Child(ren) Info

Social Media Info

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