I, the undersigned (“Parent/Guardian”), consent to photography and videotaping by Sealy Soccer Factory (“SSF”) employees, and its/their release, publication, exhibition, or reproduction of my child (“Child” or “Minor Participant”) to be used for purposes including, but not limited to, public relations, news articles or telecasts, education, advertising, marketing, fund-raising, inclusion on SSF’s website, SSF’s social media pages, SSF’s Facebook, and SSF’s Instagram.
Pursuant to the Children’s Online Privacy Protection Act (“COPPA”), SSF, located at 145 Rose Lane, Frisco, Texas 75034, wishes to collect personal information from the Child. The “personal information” of the Child includes images, photographs, video recordings, and video tapings of the Child while participating in activities at SSF. Parent/Guardian’s consent is required for the collection, use, and disclosure of the Child’s personal information. Parent/Guardian consents to SSF’s collection, use, and disclosure of the Child’s personal information by signing this document. Parent/Guardian has the option to consent to the collection and use of the Child’s personal information without consenting to disclosure of the Child’s personal information to third parties. Parent/Guardian’s failure to consent to SSF’s collection, use, and disclosure of the Child’s personal information will not prevent the Child from participating in activities on the SSF premises. SSF will not require a child to disclose more personal information than is reasonably necessary to participate in an activity as a condition of participation. Parent/Guardian can review the Child’s personal information, ask to have it deleted, and refuse to allow any further collection, use, or disclosure of the Child’s information. SSF has established and maintains reasonable procedures to protect the security and integrity of the personal information collected from the Child. If the Parent/Guardian does not wish to provide consent for SSF’s collection, use, and disclosure of the Child’s personal information, or seeks to revoke previously granted consent, Parent/Guardian must contact SSF at (408) 564-9814 and request to speak to Scott Sealy, or by e-email at firstname.lastname@example.org.
Parent/Guardian releases SSF, its officers and employees, and each and all persons involved from any liability connected with the taking, recording, or publication of said photographs, videotapes, or computer images involving the Child. Parent/Guardian waives all rights he/she may have to any claims for payment or royalties in connection with any exhibition, televising, or other publication of these materials, regardless of the purpose or sponsoring of such exhibiting, broadcasting, or other publication. All negatives and positives, whether prints, film or video, are the property of SSF or the person or entity designated by it, solely and completely.
I HAVE READ THIS RELEASE, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Sealy Soccer Factory
VERIFIABLE PARENTAL CONSENT
VERIFIABLE PARENTAL CONSENT FOR COLLECTION, USE, AND DISCLOSURE OF CHILD’S PERSONAL INFORMATION - READ BEFORE SIGNING