Animals Around the World: 4th & 5th Grade #@ID1@

Youth First Name

Youth Last Name

Preferred Name

Address

City

State

Zip

Date of Birth

Current Grade - Make a selection -4th5th

Please specify any individuals authorized to pick up your child from After School Clubs.

Emergency Contact

Photo Release
I give permission and consent for Oregon Humane Society (OHS) to allow photographs taken during youth program sessions and events of my child for promotional and advertising purposes (i.e., brochures, newsletter, consumer print, broadcast, books, internet, retail, events etc.) to illustrate and promote the youth program experience and its programs. OHS strives to provide programs and experiences to teach youth about animal welfare, compassion and kindness. OHS’ mission promotes our programs in order to continue to create a more humane world.  

By selecting yes, I agree to allow my child to be photographed and permit OHS to use my child’s likeness in promotional materials. - Make a selection -YesNo

Paws and Pixels – Telling a Pet’s Story: 6th to 8th Grade #@ID1@

Youth First Name

Youth Last Name

Preferred Name

Address

City

State

Zip

Date of Birth

Current Grade - Make a selection -6th7th8th

Please specify any individuals authorized to pick up your child from After School Clubs.

Emergency Contact

Photo Release
I give permission and consent for Oregon Humane Society (OHS) to allow photographs taken during youth program sessions and events of my child for promotional and advertising purposes (i.e., brochures, newsletter, consumer print, broadcast, books, internet, retail, events etc.) to illustrate and promote the youth program experience and its programs. OHS strives to provide programs and experiences to teach youth about animal welfare, compassion and kindness. OHS’ mission promotes our programs in order to continue to create a more humane world.  

By selecting yes, I agree to allow my child to be photographed and permit OHS to use my child’s likeness in promotional materials. - Make a selection -YesNo