Image Opt IN/OUT Form

Please use this form to opt IN or OUT for photographs and or video of your child to be published through our various media channels or as an educational resource in player and coach development.
(If you are the parent/guardian of more than one member, you must fill out a separate form for each).

Your Name (First & Last)*

Parent or Legal Guardian of Member

Your Email Address*

Your Phone Number*

Name of Child (First & Last)*

Opt Out

I DO NOT give permission for my child's photographs and or video to be used published through Hockey NSW media channels

I DO NOT give permission for my child's photographs and or video to be used as an educational resource in player and coach development

Opt In

I give permission for my child's photographs and or video to be published through Hockey NSW media channels

I give permission for my child's photographs and or video to be used as an educational resource in player and coach development

In submitting this form, I acknowledge that I am this member's legal guardian, and I have the authority to make this request.*

Yes