MusicLink Release Form

close up of man looking at a document with an autism test

MusicLink has spread across the United States with children and youth having the opportunity to grow through music and relationships with caring teachers. Continued growth requires publicity of the program. Your cooperation in allowing photos and video use for publicity purposes would be most appreciated, Please check the statements below, sign where indicated and scan the form to the email below. Feel free to add any comments or suggestions about MusicLink that may be included in articles or on social media.

I give my permission for the MusicLink Foundation to use photos, videos, and performances of my child in publications, newsletters or on social media or the MusicLink Foundation website.
I give my permission for the MusicLink Foundation to include my child in any possible TV or social media coverage.
My child’s name may accompany publicity coverage or promotional materials.
Please withhold my child’s name in publicity coverage or promotional materials.

Child’s Name

First

Last

Comments Time /

Parent/Guardian Name

First

Last

Parent/Guardian E-Mail

Signature

Clear Signature

Date / Time

Comments about your experience with the MusicLink program: