Cub Pack 150
Photo Release

I give permission for photographs of the persons listed below to be published on the website of Cub Scout Pack 150, Marietta, PA. I understand that these photos can be viewed by anyone in the world, but no identifying information will be displayed. I am over 18, and I give permission for my image to be published. Images may be used for future promotions of the Cub Scout Pack. Photo release will be revoked if request in writing is submitted to Cub Scout Pack 150. This form is also used for siblings of Scouts.

Child's name: ________________________________________________________

Child's name: ________________________________________________________

Child's name: ________________________________________________________

Child's name: ________________________________________________________

I am the parent or legal guardian of the above child(ren) under 18 years of age, and I give permission for our images to be published.

Adult's name (print): __________________________________________________

Adult's signature:  ____________________________________________________

Received by (Initials):  _________________ Date:___________________________

Position Held/Date: __________________________________________________

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