ALBERTA SOCCER ASSOCIATION
PHOTOGRAPHY / MEDIA CONSENT AND RELEASE FORM
Athlete Name: ___________________ Parent / Legal Guardian Name: ____________________
I am the above-named athlete (the “Athlete”) of the legal age in Alberta or the parent or legal guardian of the Athlete under the legal age. The Athlete is given the opportunity to participate in certain events, including games and training sessions (the “Events”), governed by the Alberta Soccer Association (“ASA”). I acknowledge and understand that ASA will be gathering images during the Events, which may include images of myself and/or the Athlete. I understand that in doing so, ASA is bound by its Privacy Policy.
“Images” includes:
- videos and still photographs of my and/or the Athlete’s likeness, poses, acts, and appearances.
- sound recordings of my and/or the Athlete’s voice; and
- written and verbal comments and information provided by me and/or the Athlete.
In consideration of the Athlete being given the opportunity to participate in the Events:
- I hereby give ASA the right and permission to produce and use images of me and/or the Athlete for purposes of promoting ASA and its activities (the “Purposes”).
- In particular, I hereby give ASA the right and permission to
- use, re-use, publish, and re-publish images of me and/or the Athlete for the Purposes, in whole or in part, individually or with other photographs, recordings, or images.
- crop, alter, and modify images of me and/or the Athlete and combine those images with other images, text, audio recordings and graphics without notifying me, in a print or electronic publication, advertising, electronic media (e.g., television, radio, CD-ROM, Internet, DVD), social media, or other form of marketing and promotion.
- use my and/or the Athlete’s names and other personal information in connection with the image, at ASA’s discretion; and
- share my and/or the Athlete’s images with Soccer Canada.
- Any authorization, right, or permission I give to ASA in this form, I also give such authorization, right, or permission to ASA’s agents and third-party contractors as ASA may authorize.
- I hereby give up any right of approval of the finished product or copy that may be used that includes my or the Athlete’s images.
- ASA shall not be required to pay any consideration for the use of my or the Athlete’s image.
- I agree to hold harmless, indemnify, and release ASA, its officers, employees, consultants, coaches, managers, volunteers, representatives, agents, and third party contractors (collectively, the “Releasees”) from and against all claims, actions, demands, costs, expenses and damages (“Losses”) that may arise from this consent and release with respect to the use of my or the Athlete’s images for the Purposes and waive any and all future claims that I or the Athlete may have against these parties at any time.
- I confirm that this Consent shall be binding upon me and, if I am a parent or legal guardian of an Athlete, that it shall also bind the other parent or legal guardian of the Athlete and the Athlete so that if the other parent or legal guardian or the Athlete shall commence any action or claim against any of the Releasees in respect of the matters herein, I indemnify the Releasees from any Losses arising therefrom.
- I understand that should I choose to withdraw my consent, I shall communicate my withdrawal to ASA in writing.
I am of the legal age in Alberta or I am the parent or legal guardian of the athlete under the legal age and before signing this document, I have read it completely and fully understand it, and that I am bound to its terms, including my heirs, personal representative and assigns.
Signature: Athlete of legal age or Parent / Legal Guardian of Athlete under the legal age
____________________________
Print Name: ____________________________
Contact Telephone Number: ____________________________
Date:____________________________
