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photo release form
Please complete a
separate form for each child
.
*
Indicates required field
Mother's Name
*
First
Last
Child's Name
*
First
Last
Complete and submit a separate form for each child
Choose One
*
Yes, I give permission for photos of my child to be included on the Columbus Chapter web site and Facebook page
Yes, I give permission for photos of my child to be included on the Columbus Chapter Facebook page
No, I do not give permission to display photos of my child on the Chapter Facebook page or web site
Re-enter Name
*
Submit
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