Tennessee Sports Hall of Fame

Photograph Consent Form

We are sending you this consent form to both inform you and to request permission for
your organizations photo/image to be published on the TSHF web site.

As you are aware, there are potential dangers associated with the posting of
personally identifiable information on a web site since global access to the Internet
does not allow us to control who may access such information. These dangers have
always existed; however, we do want to celebrate your organizations trip to the
TSHF. The law requires that we ask for your permission to use information about
your organization.
Pursuant to law, we will not release any personally identifiable information. Personally
identifiable information includes student names, ages, photo or image, residential
addresses, e-mail address, phone numbers and locations and times of class trips.
With your permission, we will only identify photos by the visiting organizations name. No
individual or personal information will be published.
If you, as a leader responsible for this organizations reputation, wish to rescind this
agreement, you may do so at any time by emailing or calling the Tennessee Sports Hall of
Fame (615-242-4750).
Check one of the following choices:

I/We GRANT permission for a photo/image that includes the organizations name
without any other personal identifiers to be published on the TSHFs public Internet site.

I/We DO NOT GRANT permission for photo/image that includes this organization to be
published on the TSHFs public Internet site.

Organization: (please print) _____________________________________

Grade or Ages Represented: _____________________________________

Print name of Contact Person: _____________________________________

Signature of Contact Person: ______________________________________

Date: __________________