WMMFA WEBSITE PARENTAL CONSENT FORM

From: Subject: WMMFA WEBSITE PARENTAL CONSENT FORM Date: Wed, 31 Jan 2007 15:54:32 -0500 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0014_01C74550.195C0630" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3028 This is a multi-part message in MIME format. ------=_NextPart_000_0014_01C74550.195C0630 Content-Type: text/html; charset="Windows-1252" Content-Transfer-Encoding: quoted-printable Content-Location: http://wmmfa.150m.com/consentForm.html WMMFA WEBSITE PARENTAL CONSENT FORM

Free Web Hosting | Web Hosting | Free Web Space | = Web = Hosting

TEAM: ________________________________

___ Football ___ Cheering

____ I DO NOT want my child=92s image to appear on the WMMFA = website.

____ I give consent for my child=92s image to appear on the West = Milford Midget=20

Football website. I understand that this may be in picture or video=20 format.

Child=92s Name: __________________________________

Parent/Guardian: __________________________________

Signature: __________________________________ Date: = ____/_____/_____

____ I DO NOT want my child=92s image and /or name to appear in the=20 newspaper.

____ I give consent for my child=92s image and/or name to appear in = the=20 newspaper.

Child=92s Name: __________________________________

Parent/Guardian: __________________________________

Signature: __________________________________ Date:=20 ____/_____/_____

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