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Photo Release for www.pack85.com

Please fill in the form below and click the "Submit" button on the bottom of the page.

(All information will be held confidential. Security and safety is our main priority)

Childs Info:	Last Name	First Name
Parent / Guardian Info:	Last Name	First Name
Address:
City
State
Zip:
Phone:
	eg: 555-555-5555
Email:
	I give my permission to Cub Scout Pack 85 to use photos of my child, (and any siblings attending an event) on the Official Pack website: www.pack85.com. I hereby release Pack 85, the Theodore Roosevelt Council, and the Boy Scouts of America from any and all liability and legal or equitable claims of any kind. I understand that if any names are to accompany any photos or articles, first names only will be used.
Today's Date:	Month Day Year

Cub Scout Pack 85 - Lynbrook, NY