Photo Release Horizon Gymnastics
74067 P Road, Holdrege, Nebraska 68849
Phone: 308.995.2335 Fax: 308.995.2264
By returning this form, I hereby give my permission for use of my child(s)
photograph(s) taken by Horizon Gymnastics or supplied to Horizon Gymnastics by me,
my family or a photographic studio, for exhibition, advertising, promotion, or web.
It is my understanding that these photograph(s) will be used in accordance with the
highest standards of good taste, and in consideration of this, I do hereby relinquish
ownership and assume full responsibility for any and all repercussions resulting from the
publication of these photograph(s).
Student Name(s) (Please Print): _____________________________________________
Parent Name (Please Print): ________________________________________________
Parent Signature: _________________________________________________________