Guardian Name *

First Name

Last Name

Player Name *

First Name

Last Name

Phone *

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PHOTO/VIDEO RELEASE AUTHORIZATION *

FOR PARENTS OF MINOR ATHLETES: I, the parent or legal guardian of the ATHLETE listed above, grant Silva Academy, LLC my permission to use all photographs, recordings and videos obtained during any Silva Academy, LLC events and programs, including any photographs, recordings and videos obtained by Silva Academy, LLC during any prior event or program, for any legal use, including but not limited to: publicity, social media, copyright purposes, illustration, advertising, and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use. _________________________________________________ FOR ADULT ATHLETES: I grant Silva Academy, LLC my permission to use all photographs, recordings and videos obtained during any Silva Academy events and programs, including any photographs, recordings and videos obtained by Silva Academy, LLC during any prior event or program, for any legal use, including but not limited to: publicity, social media, copyright purposes, illustration, advertising, and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

I have fully read and agree with the terms and conditions above