I hereby certify and agree that this Minor has my approval to participate in Broadway Bound's Summer Spotlight Program.

I hereby consent to Broadway Bound Children’s Theatre and their assignees the right to record the image and/or voice and use the artwork and/ or written work of my child/charge listed above, on videotape, on film, on photographs, in digital media and in any other form of electronic or print medium and to edit such recording at their discretion. I understand that my child’s full name, address and biographical information will not be made public.

I further grant Broadway Bound Children’s Theatre and their assignees the right to use, and to allow others to use, my child’s image and/or voice on the internet, in brochures, and in any other medium and hereby consent to such use. I further release and relieve Broadway Bound Children’s Theatre, employees, and other representatives from any liabilities, known or unknown, arising out of the use of this material. I certify that I have read the Media Consent and Release Liability statement and fully understand its terms and conditions.