I hereby give my consent for the library to use my photograph and likeness to be used in its publications, including its website. I release them from any expectation of confidentiality for the undersigned minor children and myself and attest that I am the parent or legal guardian of the children listed below.
Signature: _________________________________ Date: ___________
Names and Ages of Minor Children:
Name: ______________________________________ Age: _____
Name: ______________________________________ Age: _____
Name: ______________________________________ Age: _____
Name: ______________________________________ Age: _____
Name: ______________________________________ Age: _____
Name: ______________________________________ Age: _____