Electric City Soccer Club, from time to time, wishes to use photographs ...

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Electric City Soccer Club, from time to time, wishes to use photographs of our participants to publicize our program(s), and enhance our website and Facebook page. We would like to ask your approval to use your child’s photo in promoting our program(s) to the public. If you give this permission, please sign this form and return it to us. Thank you,

Rick Waldenberg Club President

Participant’s Name _______________________________________________ Parent/Guardian Name ___________________________________________ Email address ___________________________________________________ Phone Number __________________________________________________

______________________________________ Parent/Guardian Signature

Please return this form to:

ECSC Attn: Karin Deal P.O. Box 1648 Great Falls, MT 59403

_________________ Date