Cub Scout Pack 325, Dysart, Iowa			Tamaha District, Boy Scouts of America
Permission to Publish Youth Pictures
On council/district/pack web sites
	Note: Contact information related to Cub Scouts, Boy Scouts, or Varsity Scouts youth members (under 18 yrs. old) will not be listed on Pack, District, or Council websites.
I certify that I am the parent or legal guardian of the participant listed below, and I give my consent for his/her picture(s) to be published on the Pack 325 web site. A first name only will be permitted for those included on this form.
The Mid Iowa Council, Tamaha District, and Pack 325 (Dysart, Iowa) are not responsible for any liability and damages, in any form, whether foreseeable or not, including consequential damages, for publishing any pictures of any individual.
I also give permission to publish pictures of others in my family without names. If a first name is needed specific permission will be acquired prior to publication.
This permission will stay in effect until revoked by me either verbally or in writing.
_____________________________________
Parent or Guardian (Printed)
_____________________________________		___________________
Parent or Guardian (Signature)		Date
List Names of Family members included in permission.
_____________________________________		_____________________________________
_____________________________________		_____________________________________
_____________________________________		_____________________________________

Cub Scout Pack 325, Dysart, Iowa			Tamaha District, Boy Scouts of America
Revocation of Permission to Publish Youth Pictures
On council/district/pack web sites
	Note: This revocation will be put into effect as soon as it is received, given reasonable time to remove any photos and names from the website. This may take up to seven days or more.
I certify that I am the parent or legal guardian of the participant listed below, and I hereby revoke all permissions to publish pictures and/or names of my family members on the pack, district, or council websites.
_____________________________________
Parent or Guardian (Printed)
_____________________________________		___________________
Parent or Guardian (Signature)		Date