Media Permission Form

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Permission to post: Name, Photo, or Video on the MMTA website, newsletter, blog, or social media pages.

Date: *

YYYY

STUDENT Name *

PARENT or GUARDIAN Name (on behalf of a Student under age 21) *

Which event is this related to? (select ALL that apply) *

Judged Festival

Bay State Piano

Bay State Strings

Musical Achievement Evaluations

Other:

Required

Email *

Cell Phone *

Home Phone *

Address *

By checking the following box, I give MMTA (Massachusetts Music Teacher Association) permission to use the above STUDENT name, and related digital photo and/or video recording, on website and social media platforms (e.g. but not limited to: Facebook, Instagram, Youtube, etc) hosted by MMTA and accessible on the internet. I am over the age of 21 and, if signing on behalf of a minor dependent, I have the right to enter into this agreement on behalf of my minor dependent. *

I give my permission.

Required

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