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Video / Photography Permissions 2020-2021
Thank you for completing this survey. Many of these questions are duplicated in the Universal Forms. Please complete both the form and the survey, one per child.
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* Indicates required question
Parent / Guardian Name (First/Last)
*
Your answer
Student's Name (First/Last)
*
Your answer
Teacher's Name
*
Your answer
Grade Level
*
Preschool
TK/Kinder
First
Second
Third
Fourth
Fifth
Other:
I give my permission to have my student interviewed, photographed, and/or video recorded by news media.
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Yes
No
Other:
I give my permission to have my student photographed and/or video recorded by the district/school. (Photos and videos may be used on the school/district websites, brochures, social media, etc.)
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Yes
No
Other:
I give my permission to have my student's name published in order to credit his or her work.
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Yes
No
Other:
I give permission to have my student's photograph included in the school yearbook.
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Yes
No
Other:
I give permission to have my student recorded during classroom Zoom meetings.
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Yes
No
Other:
I give my permission to have my student's voice recorded during classroom Zoom meetings.
*
Yes
No
Other:
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