YMCA of Greater Erie

Thank you for completing the Code of Conduct, the next step is to complete the Media Release form below. You can contact [email protected] with any questions.

Media Release

From time to time, as part of the YMCA Volunteer Program, the YMCA and YMCA volunteers are photographed for marketing purposes, engaged in writing or art projects for promotion and publication, highlighted in news stories (newspapers, radio and/or television), and other projects where you could be photographed, interviewed, or otherwise recognized for your involvement in the program.

Please indicate your acceptance or denial of you and/or your work being used for purposes of promotion and publicity in conjunction with YMCA organized and sponsored activities.*
- I give permission to be photographed, interviewed, quoted, and/or receive recognition for my work and involvement while participating in the YMCA Volunteer Program.
- I do NOT give permission to be photographed, interviewed, quoted, and/or receive recognition for my work and involvement while participating in the YMCA Volunteer Program.
Name*
First Last
Signature*
Date*
MM slash DD slash YYYY

Upon clicking submit you will be taken to the Background Check Waiver, the final form to complete.

For Persons Under the Age of 18:

For persons under the age of 18 a legal guardian must submit this form. Please indicate your acceptance or denial of you and/or your work being used for purposes of promotion and publicity in conjunction with YMCA organized and sponsored activities.*
- I give permission for my child to be photographed, interviewed, quoted, and/or receive recognition for their work and involvement while participating in the YMCA Volunteer Program.
- I do NOT give permission for my child to be photographed, interviewed, quoted, and/or receive recognition for their work and involvement while participating in the YMCA Volunteer Program.
Guardian Name*
First Last
Signature*
Date*
MM slash DD slash YYYY
Minor's Name*
First Last
Signature*
Date*
MM slash DD slash YYYY