Youngstown Salem Boxing Club has my permission to use my photograph to promote the gym. I authorize the use of their image, voice, or likeness in photographs, audio recordings, or video recordings for, but not limited to, print brochure, website, posters, social media, and media articles. I give Youngstown Salem Boxing Club creative permission to alter the photographs, provided that the photographs are not altered in an explicit manner or used to maliciously represent myself. I also understand that no royalty fee or other compensation shall become payable to me by reason of such use.
I certify that I am 18 years of age or older. If under the age of 18, a parent or guardian must sign this release.
Printed Name: {name}
Date of Birth: {dob}
Signature of Athlete:
Date {sign_date}