YAC Media Release & Parental Consent, Waiver, and Release of Liability

Youth Advisory Committee Media Release Form

Please provide all the information asked for below

Youths Name(Required)

First Last

Youths Address(Required)

Street Address Address Line 2 City ZIP / Postal Code

Email(Required)

Please check all that apply:

This material can be used by Otsego Community Foundation from the date of this release for the purpose of promoting youth philanthropy in the following forms -(Required)

News Release

Photographs

Video

Audio

Website

Social Media

Date(Required)

Relationship(Required)

YAC Member

Parent or Legal Guardian

Parnet or Legal Guardian Name(Required)

First Last

Youth Advisory Committee Member Parental Consent, Waiver, and Release of Liability

In consideration of the opportunity to serve as a member of the Otsego Community Foundation (OCF) Youth Advisory Committee (YAC), the undersigned YAC member, and the undersigned parent or legal guardian if the YAC member is under age 18, agrees to waive, release, and hold harmless the OCF and their respective agents, officers, board members, representatives, employees, and volunteers (the “Releasees”) from and liability to the undersigned and their personal representative, heirs, assigns or property of the undersigned YAC member relating to attendance at any event or activity, or transportation to or form the event or activity, whether caused by the negligence, gross negligence, or recklessness of the Releasees or otherwise. The undersigned have read the Waiver and Release of Liability and voluntarily sign.

Youths Name(Required)

First Last

Date(Required)

Parent or Legal Guardian Name(Required)

First Last

Parent or Legal Guardian Email(Required)