WAIVER (MUST BE SIGNED)
I AUTHORIZE AND
GIVE MY PERMISSION TO WEST VIRGINIA SPORTS ON THE NET
TO USE THE ABOVE INFORMATION AND MY (CHILD'S) PICTURE ON ITS INTERNET PAGE.
| PLAYER NAME: | _____________________________________ |
| SPORT: | _____________________________________ |
| DATE: | _____ /_____ /_____ |
| SIGNED: | _____________________________________ (BY PARENT OR GUARDIAN IF UNDER 18) |
Send non-returnable
photo and a
check or money order for $25 to:
WVSPN
P.O. Box 58394
Charleston, WV 25358