Kent Swim and Tennis Club - WWW Site Permission Form

I give the Kent Swim and Tennis Club (KSTC) permission to publish the following items on the KSTC internet site:

	Child's first name
	Child's photograph

the Child's name is not to appear in the same area as the picture

Please cross out any of the above items that you do NOT want included on the web site.

Child's Name _____________________

Child's Signature ______________________________

Parent/Guardian Signature ___________________________

Date _____________________________