MARU MARTIAL ARTS
500 Virginia Ave. # 1202
Towson, Md 21286
410-494-4963
I hereby authorize Maru Martial Arts to take photograph,
videograph or otherwise record my image, sound, and likeness while
I am participating in any activity sponsored by or connected with
Maru Martial Arts. I agree that such recordings may be published
by Maru Martial Arts to third parties in advertisements, books,
or instructional materials. I hereby waive any and all right to
any compensation in connection with Maru Martial Arts's publication
of such recordings, even if Maru Martial Arts derives a profit
from the publication.
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Witness ........................................................Signature
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Printed Name
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Acknowledgment and Agreement of Legal Guardian, if applicable:
Signature______________________
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Printed Name
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Date