Release form for Webmaster Anthony Ignomirello

I Parent/Guardian of ________________________________________________

Player - Son/Daughter please print

Give permission to Anthony Ignomirello put Name & or Pictures on an internet web Site/Page for sports.

No social security numbers, or Home addresses will be Shown or allowed on this site.

If you do not give permission for your Son/Daughter they will not be included in the team roster on the web Site/Page.

Parent/Guardian Name ________________________________________________

Please print

Parent/Guardian Signature _______________________________________________

Please sign

Thanking you in advance,

Anthony Ignomirello – WebMaster

Mail to P.O. Box 1136 Kearny N.J. 07032 Attention : Soccer Release