AUTHORIZATION FOR RELEASE OF PHOTOS/VIDEO FOR PUBLIC RELATIONS

Use of Name, Photograph and Identity in Connection with Advertising and/or Promotion of the Organization for valuable consideration I, the undersigned, hereby irrevocably consent to and authorize the unrestricted use by Boys & Girls Clubs of Laurens & Johnson, Department of Human Services and their subsidiaries, affiliates and advertising agencies of my child’s name, photographs, works of art and identity in various BGCLJ website, social media, local newspaper and collateral material. I hereby waive, and release and discharge said companies and all agents, employees and officers of the companies, including any that I do not now know of or anticipate arising n the future, none of which would affect my execution on of this release if know to me, and waive all rights to respect to such use of my name, photograph, identity, and personal information including but not limited to publicity, privacy, psychological injury and liability.