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First Name:(*) |
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Last Name:(*) |
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Home Phone:(*) |
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Cell Phone: |
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Relationship:(*) |
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Email:(*) |
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Confirm Email:(*) |
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Address Line 1:(*) |
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Address Line 2: |
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City:(*) |
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Photo Release:(*) |
I, personally and on behalf of any of my children, give my permission to use my and/or my child's name, photographs, videos, quotations and likeness in any advertisements or promotions performed in connection with the Kids & Pros, Inc., Starbucks and The Atlanta Silverbacks camps, clinics, Pros & Joes Day events or other affiliated events, and agree that neither I nor my child shall be entitled to any compensation for such use.
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Acknowledgement:(*) |
I have read and agree with the Kids & Pros, Inc., Starbucks and The Atlanta Silverbacks Code of Conduct Policy and General Release |
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Referred By: |
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Association: |
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