REGION III LOUISIANA SCIENCE OLYMPIAD
2020 Photo Release
Each team member and coach must complete this form and bring to the registration table (GYM) at the
regional competition on Saturday, March 28, 2020.
I hereby grant Bossier Parish Community (BPCC), its affiliations, associations, exhibitors and
distributers the full unrestricted right to the use of my picture, voice and likeness in multimedia
presentations.
I also agree to hold BPCC, its affiliations, association, exhibitors, distributors, properties and assets
harmless in all litigations regarding this agreement and participation in the above mentioned
program and its content.
Participant Signature Date
City:
Zip: Phone:
Participant Name
Address:
State:
Email address:
For Participants under the age of eighteen (18) years listed above:
I hereby consent and agree to the above as the Parent/Legal Guardian of
(printed minor’s name), in which case "I", "me"
and "my" as used herein shall refer to said minor.
Parent or Legal Guardian Signature Print CLEARLY Parent or Guardian Name
click to sign
signature
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click to sign
signature
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