Renaissance Media Consent 2019-2020
This form ONLY necessary if you chose a Media Restriction during Express Check-In.

If you did not allow your student to be interviewed, photographed or recorded by school staff, District or news media, or if you chose Media Blackout on the Parent Media Consent Form during District Express Check-In, your child’s image will not be allowed to be used on ANY Renaissance communications. Many Renaissance families want to see pictures of their children in crew blogs and on other school media, but do not want this permission granted to District and/or outside media.*

One of our school’s goals is to improve communication to parents and the community about the events and wonderful learning taking place at Renaissance. In the digital age, many of our communications involve the use of the internet, including the school’s website and social media (such as teacher and/or crew blogs).

Please consider allowing Renaissance to use images of your child so that Renaissance can share with you and our community what makes us the most proud: our students! I want to assure families that if your child’s name is used, only his or her first name will be associated with the image. Your child’s last name will not be associated with any images on any websites or social media without your express consent (with the exception of the school yearbook where the last name will be used; unless you chose Media Blackout).  

Warmly,
Ms. Deborah

*Per District Media Consent, there is no expectation of privacy during school assemblies or other large school gatherings, sporting events, off-campus field trips or extra-curricular activities. Privacy can not be guaranteed in public locations.

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School Publishing *
I will ALLOW my child’s photograph, video image and schoolwork to be published on Renaissance digital media (websites, blogs, social media) and/or used for other Renaissance promotional purposes. This permission overrides any District Media Consent forms submitted for my child and the images will be used by Renaissance only.  (Renaissance will continue to restrict District and outside media for my child.)
Student's First Name *
Student's Last Name *
Student's 2019-2020 Teacher *
Student's First Name
Second Child (if applicable)
Student's Last Name
Second Child (if applicable)
Student's 2019-2020 Teacher
Second Child (if applicable)
Student's First Name
Third Child (if applicable)
Student's Last Name
Third Child (if applicable)
Student's 2019-2020 Teacher
Third Child (if applicable)
Electronic Signature of Parent/Guardian
By entering my name below, I understand that I am providing an electronic signature which will serve as authorization and verification of the accuracy and completeness of the information I have provided.
Parent/Guardian Full Name *
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