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Click here for a Printable Version of the Photo Release Form




Northern Dutchess Boys Youth Lacrosse


Photo Release Form for Minors



I, being the parent or guardian of the child/children listed below, hereby consent that

photographs or videos taken of my child during the Lacrosse Season may be used as indicated below.  I acknowledge that this media may be used even after my child is

no longer involved with Northern Dutchess Boys Youth Lacrosse. 


These pictures and/or videos may be used on the ND Lacrosse Website, Team Photo Sharing Websites and in Local News Media. 



           I DO NOT give my consent to have photographs of my child/children used by Northern Dutchess Boys Youth Lacrosse. 



Name of Player:                                                                         Grade                         

Name of Player:                                                                         Grade                                            

Name of Player:                                                                         Grade                          


Signature of Parent                                                                        Date                        



Please sign and return this along with the Code of Conduct Form. This signature will be kept on file.