ADULT LEADER FORM:

PERMISSION FORM FOR PUBLISHING

ADULT LEADER INFORMATION

 ON THE BSA TROOP 828 WEBSITE AND RELATED WEBSITES

With your permission, we would like to be able to publish your first and last name, leadership position in the troop, and photographs of you engaging in troop activities.

Please indicate your preferences by checking the appropriate spaces below.  We will do our best to honor all of your preferences.  If any photograph or information about you that you find objectionable appears on our website, please notify us and we will remove it.

I give my permission for the following information about me to be displayed on the Troop 828 website and related websites.

Please check YES or NO for each of these:  YES NO
My first and last name    
My leadership position in the troop     
Photographs of me participating in troop activities    
My phone number    
My email address    

 

Signature  ________________________________________________

(Please print the information below.)

Name ___________________________________________________

Date  ____________________________

Revision date:  3/27/2003