The Mindful Gymnast would like to take your photograph for promotional purposes. These images may be used on social media such as Instagram/Faceobook or publication on The Mindful Gymnast Website.

Person(s) in Photograph

I agree to allow The Mindful Gymnast to take photographs of me (my child) and grant permission for these to be used by The Mindful Gymnast in publication, press articles, promotional material and website use.

Name of Child

First Name

Last Name

Name of Parent/Guardian

First Name

Last Name

Email

Phone

(###)

###

####

Electronic Signature of Parent/Guardian

Electronic Signature of Child

Date

MM

DD

YYYY

Photography Conset Form

The Mindful Gymnast