Media Release Permission Form

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As a parent or guardian of the students listed below, I hereby consent to the use of photographs/videos taken during the course of the school year. As it pertains to the use of these photos/videos for publicity, promotional, and/or educational purposes (including print publications, school web site, school Facebook/Instagram or other media sources), please see the following stipulations concerning the use of photographs for this student.

I give full consent for my student to be photographed/videoed and their picture used as described above. *

Yes

Only in groups

*Please note* All students will be photographed for school pictures.

Name of student(s): *

Signature of parent: *

Date: *

YYYY

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