NOTIFICATION OF POSSIBLE MEDIA VISITS/PHOTO RELEASE FORM
Weldon City Schools uses photographs, slides, videos, or illustrations of students for many purposes related to WCS business. This form allows you to grant or deny permission to WCS to release your child’s image for display or publication. This form also allows a parent or guardian to choose whether or not their child may be identified by name on the school or district’s websites. Student names may be released unless a parent or guardian has expressly contacted the school and requested their child’s “directory information” not be shared. However, as a safeguard, the district does not directly publish student names to the Internet unless given permission by a parent or guardian.

Parents have two options for granting or denying consent:

• Parents may deny permission for any display or publication of their child’s image. You should select this
option if you do not want your child’s photograph to be used on the WCS or individual school websites,
in WCS or school publications, or in release to external organizations (such as PTA) or the media.

• Parents also may grant permission for their child’s image to be published or displayed in print, video,
and/or digital media. Selecting this option means that your child’s photograph and name may appear in WCS or school publications, on the WCS or individual school websites, and may be released to external organizations (such as PTA) or the media.

Please complete this form and have your child return it to his or her school. This consent form remains valid throughout your child’s K-12 experience with the Weldon City Schools or until a new form is completed and signed by a parent/guardian or eligible student.
       
Sign in to Google to save your progress. Learn more
Choose one of the following: *
Required
Student's Name *
Student's Grade *
Student's School *
Parent/Guardian's Name: Typing your name serves as your signature. *
Phone Number *
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Weldon City Schools. Report Abuse