SLACKS CREEK RUGBY LEAGUE

1. I Declare that I am the parent/legal guardian of the child mentioned earlier,

2. I agree to Slacks Creek Rugby League, its employees, officers, agents, contractors, and away host venues (“Slacks Creek Rugby League”)

(a) making images or recordings, whether sound, digital, or otherwise, of me and the Children (“Images and Recordings”);

(b) using, publishing, or reproducing the Images and Recordings in any form (in whole or in part) and by any medium, including but not limited to newspapers, magazines, brochures, television advertisements, promotional videos, websites, CD-ROM or other multi-media, for public relations, promotions, commercial and advertising purposes (“Promotional Materials”); and

(c) retaining or storing the Images and Recordings (including those incorporated into Promotional Materials), in hard copy or digitally, including but not limited to, deposit of the Images and Recordings into a Slacks Creek Rugby League Image Library;

3. I agree that the rights granted to Slacks Creek Rugby League under clause 2 of this Photo Consent Form are perpetual and that I will not receive any payment, royalty, or other consideration (whether monetary or otherwise) from the Slacks Creek Rugby League in connection with the making, use or storage of the Images and Recordings;

4. I agree to Slacks Creek Rugby League collecting, storing, handling, accessing, managing, transferring, using, and disclosing personal information about me and the Children, including but not limited to our name, details, and image, in connection with the Images and Recordings or the Promotional Materials;

5. acknowledge and agree that any Promotional Materials which refer to the Child, expressly or by implication, are, at the date of publication, made in good faith and are not intended to defame or offend the Child or bring the Child into disrepute and, to the best of the State’s knowledge, are true and correct;

6. agree that Slacks Creek Rugby League is the owner of the copyright in the Images and Recordings and the physical Images and Recordings; and

7. acknowledge that a representative of Slacks Creek Rugby League has explained the contents of this Photo Consent Form to me and I am making this declaration of this Photo Consent Form of my own free will, on the full understanding and comprehension of the terms of this Photo Consent Form.