Media Release Form (SRACS/2020-21)
Representatives from the news media or the SRCS district office often visit the school campus to take photographs or videotape of students involved in various educational activities. Additionally, the school and/or district will take photographs of school activities to include in print and website publications, including digital or electronic promotional media forms. Please indicate by checking the appropriate box below whether your student has your permission to be photographed, videotaped, or interviewed while at school and to have those images distributed through print or electronic media sources. In some cases, images may appear in the newspaper or television.
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Email *
Please select ONE: *
Student Name: *
Student Grade/Class: *
Parent Name: *
By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
A copy of your responses will be emailed to the address you provided.
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