We as a school district want to celebrate your child, his/her work, and his/her participation in certain programs or events.  We are requesting permission for your child's image to be published.
Please check the choice below that is most appropriate for your family.  
Your signature/permission will remain in effect for the duration of the child's schooling at Middletown.  However, you may change this agreement/permission at any time by writing to the principal of your child's school.  Your wishes will be honored immediately upon receipt of the request.
Please fill out this form for each child if you have multiple children enrolled in the school.

Full Permission - this includes the following, as appropriate:  Image/audio of my child, and/or personal identifiers such as name, grade, school and teacher's class.  This may include, but is not limited to , school/district website,  local papers and school publications, including yearbooks/memory books, DVD's of school events (performances/shows), etc.

Partial Permission - This includes the following, as appropriate:  Image/audio only, with no personally identifying information except school.

Permission is NOT Granted - My child's image/audio may not be published on the district and/or school's website or in print media generated by and under the control of the school district.