Media Opt-Out Declaration

Please complete and submit this form ONLY if you do NOT wish for Western Sydney Wanderers FC to record your child’s participation and appearance for use on any form of media across our community football programs. 

This photo opt-out is applicable for up to 12 months and applies to any of our community football programs. 

Media Opt-Out Declaration

I do not wish for Western Sydney Wanderers to record my child’s participation and appearance across any form of media, including audio, video, and photography. I understand Western Sydney Wanderers will make a reasonable effort to comply with this request. If I become aware of a recording with my child’s participation and/or appearance, I will notify Western Sydney Wanderers. 

I hereby confirm that I am the parent/legal guardian of the child stated below. I further affirm that I have read this Opt-Out Form and am familiar with its contents.

Media Opt Out Form
I am completing this form on behalf of:
Your Name
Your Name
First
Last
Parent/Guardian's Name
Parent/Guardian's Name
First
Last
Your Child's Name
Your Child's Name
First
Last
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