Photo Release

Your Name *

Parent or Guardian Email *

Parent or Guardian Phone *

Player Name *

Player Number *

Team Name *

Uniform Identifying Marks *

Blue laces, yellow stick, Bauer red and black gloves

Photo Release *

I certify that I am the parent or legal guardian of the player listed above.

I authorize and consent the use of my player photo by Grotto Photo Company or any other organization.

I understand I may revoke this authorization and consent at anytime by writing to grottophoto@gmail.com; digital photos will be removed from public platforms managed by Grotto Photo within 3 business days; printed materials will no longer be produced.