Media release for minors (under 18)Please enable JavaScript in your browser to complete this form.Release for Minor Children (Under 18)I hereby grant permission to The Reform Alliance of Arkansas to take and use photographs and/or digital images of minor child for use in news releases and/or educational materials. This could include but not be limited to electronic or printed publications and materials, web sites, social media or materials for promotional events. I further agree that minor’s name and identity may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions shall be the property of The Reform Alliance of Arkansas.Child's Name *FirstLastParent's Name *FirstLastDateAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmit