Media Release Form
From time to time the Youth Ambassadors Of Virginia Presents “Weekend Youth Retreat” Program has opportunities to promote the program through local media, websites, brochures, or other mediums.  Pictures of the students are often used in these promotional or informational materials.  Your permission is necessary for your child to be photographed for use in such materials.
Child(ren)s Name *
Email *
Address *
I give permission for photographed individually and/or in-group activities by a photographer authorized by the Youth Ambassadors Of Virginia Presents “Weekend Youth Retreat” Program.  These photographs may be used in promotional or informational materials (including print, video, or electronic) for the Youth Ambassadors of Virginia.  TYPE I AGREE
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