All Players please print and get your parents/guardian to sign our photo and media release form. Hand in to Coach Wilson so that we can increase the awareness of the outstanding players who play for Wensum Warriors.

Photo and other Media Release

I, ______________________(print name) on behalf of myself, my successors and assigns hereby grant to Wensum Warriors Basketball, their employees and/or agents permission to interview me and/or to use my likeness in photograph(s) and /or video in any and all of its publications and in any other media, whether now known or hereafter existing, controlled by Wensum Warriors Basketball, in perpetuity, and for other use by Wensum Warriors Basketball.

I further waive and release Wensum Warriors Basketball, their agents and assigns from any and all claims, demands, actions and causes of actions, which I have now or may have against them, or any of their officers, agents, employees or servants by reason of the use said photographs, video or other media, known or unknown which I have or may have against Wensum Warriors Basketball and I hereby covenant that no suit shall ever be brought thereon for any reason by me or any person on my behalf against Wensum Warriors Basketball, their officers, agents or employees or servants relating to the interview and/or the photograph(s)/video and use thereof.

Name (print full name)____________________________________________________


Date: _______________

Parent/ Guardian Full Name (If under 18)


Parent/ Guardian Signature__________________________________

Contact Number__________________________________