2021-22 Media Release Permission Form
This form must be filled out separately for each individual child in each family.
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Date: *
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Name of Parent(s)/Guardian(s) completing this form.  (By completing this form, I am giving full consent in lieu of a signature.) *
Name of child (one child per form) **Yes, we do need you to fill out one form for each individual child in your family. *
Grade Level: *
I/We hereby give permission to St. Patrick School to use sound, video and photographic images of my son/daughter for news releases, brochures, social media, including but not limited to St. Patrick School sponsored Facebook, Instagram, and Youtube accounts, and/or any other school related productions.  Additionally, I give permission for my son's/daughter's image, work, and first name to be used on the school web page.  No last names will be used on any school related website or social media platform.   *
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