Photograph/Videotape Release – WELCOME TO KIDS UNIVERSITY

Kids University Photography / Video Release Form I hereby grant permission for the provider specified below, to record the participation and appearance of my child/children by photograph and / or videotape in connection with daily daycare activities for the purpose of news releases, reporting and assessing the progress of children and the program. Kids University is authorized to exhibit or distribute such photograph(s) and/or videotape in whole or in part without restrictions or limitations for any educational or promotional purposes. Such photograph(s) and/or videotape may, for example, appear in printed or visual materials for Kids University web site. The Undersigned hereby jointly and severally releases, acquits and discharges Kids University provider from any actions, agreements, claims, controversies, demands, judgments, liabilities, proceedings, and suits, whether arising in equity or in law regarding such participation and appearance by said child/children. This Release shall remain binding upon all successors in interest and personal representatives of the parties, to the extent permitted by law. PRIVIDER: KIDS UNIVERSITY 1015 TENNESSEE AVENUE ST. CLOUD, FORIDA 34769

I Agree to the conditions above

Kids University Photography / Video Release Form

Childs Name *

First

Last

Child #2 Name *

First

Last

Child #3 Name *

First

Last

Signature of Parent/Guardian *

Date *