Teddy Bear Picnic Contact/Release Form 

Event taking place at Blue Meadows on Sunday, July 23, 2017. 

Parent's Name *
Parent's Name
Parental Consent
I confirm that am the legal parent or guardian of the above named minor. I grant to Kelsie Kelly Photographer, the right to take photographs of said minor in connection with the above-identified event.
Photo Release
I agree that Kelsie Kelly Photographer may use such photographs of the above named minor for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content*. *Images will only be shared with EPS Wives via the EPS Wives Facebook Page and private online gallery.