Dear Parent:

Please be advised that during the year your child may be photographed, video taped or interviewed at various school sponsored events. With your consent, the photograph, video or interview may be reproduced and released for the use by the media, i.e., newspapers, brochures, videos, television and through the internet.

Please indicate your preference below.

 
 _______________________            
         (Student's Name)

 ___Yes.   My child's photograph/video/interview may be reproduced and released for
                 use by the media.

 ___No.    My child's photograph/video/interview may not be reproduced and
                 released for use by the media.

 

 __________________________                                              ______________
                (Signature)                                                                            (Date)

Return this signed form to:

CONTACT PERSON: Homeroom Teacher                                      

SCHOOL NAME: Kenwood K-8 Center                                         

SCHOOL TELEPHONE: (305)271-5061                                        

 

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