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Media Release Form

Permission to use or not use a child's image in Academy media.

Session HKA-20260914-WQA64MIRUCLFdraftSaved

Parent Release for Media Recording

Please identify your child and select one of the permission options below. Media may include photographs, images, and video used in printed materials, brochures, newsletters, the Academy website, and other digital communications.

Child's full name *

Permission Selection

Select one option * GRANT permission for my child's image to be used in print, video, and digital media. I understand that the images may be used for Academy purposes without further notice and that my child's name will not be used with video or digital images. DENY permission to use my child's image in any print, video, or digital media.

Parent/Guardian Acknowledgment

By signing below, I confirm that I am authorized to make this selection for the child named above.

Parent/guardian name *

Parent/guardian signature (type full legal name) *

Date *

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Submitting finalizes this session. Review every answer before continuing.