PHOTO & VIDEO CONSENT FORM FOR SOCIAL MEDIA

Child’s Full Name: Child’s Full Name: First Last
Date of Birth: Date of Birth: / MM / DD YYYY
Parent/Guardian Name: Parent/Guardian Name: First Last
Relationship to Child:
I, the undersigned, give permission to Melissa Kelly Dance Academy (MKDA) to take and use photographs and/or video recordings of my child, for use on official social media platforms including but not limited to:

- Facebook Page
- Instagram
- MKDA Website

I understand that:

- My child’s image or video may be viewed publicly by anyone who accesses the social media platforms.

My child’s name:

I, the undersigned, give permission to Melissa Kelly Dance Academy (MKDA) to take and use photographs and/or video recordings of my child, for use on official social media platforms including but not limited to:

- Facebook Page
- Instagram
- MKDA Website

I understand that:

- My child’s image or video may be viewed publicly by anyone who accesses the social media platforms.

My child’s name: May be used alongside the image/video May NOT be used (initials or no identification will be used instead)
These images/videos may be used for promotional, educational or informational purposes related to Melissa Kelly Dance Academy’s mission or activities.

I acknowledge that I will not receive compensation for the use of these images/videos. I also understand that I may revoke this consent at any time by submitting a written request to the Melissa Kelly Dance Academy.
Consent:

These images/videos may be used for promotional, educational or informational purposes related to Melissa Kelly Dance Academy’s mission or activities.

I acknowledge that I will not receive compensation for the use of these images/videos. I also understand that I may revoke this consent at any time by submitting a written request to the Melissa Kelly Dance Academy.
Consent: I give permission for my child’s photo/video to be used on social media as described. I do NOT give permission for my child’s photo/video to be used on social media.
Signature of Parent/Guardian:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
Contact Information:
Phone Phone - ### - ### ####
Email

PHOTO & VIDEO CONSENT FORM FOR SOCIAL MEDIA

Contact Information: