Youth Soloist Competition Photographic and Information Release Form

This is the Photographic and Information Release Form that must be submitted with your Youth Soloist Competition Application Form.

We will be taking a picture of you following your performance to use on our Kalamazoo Concert Band website and Facebook page featuring pictures of all the Youth Soloist Competition performers. To do that, we need to have written permission from you or from your parent/guardian if you are a minor.

Name(Required)

Name of student photographed/sharing information:(Required)

First Last

Signature of student photographed/sharing information:(Required)

Name of parent/guardian if student is a minor:

First Last

Signature of parent/guardian if student is a minor:

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Date(Required)