Media Consent Form

top of page

Use tab to navigate through the menu items.

Media Release & Consent Form

First Name

Last Name

Email

Today's Date

Name of Organization

Name of Workshop

Your Signature

I hereby give my cosent for AWC to use my photographs.

Thanks for submitting!

Los Angeles, CA

I am interested in:

Student Coaching

Educator & Parent Trainings

Behavior Consultations with Lance

Joining the team!

Your message has been sent successfully!

bottom of page