Publicity Form - Sample - (last update: 7/10/08)

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PUBLICITY FORM On occasion, Holy Family School takes photographs or makes an audio or video tape recording of children and/or adults involved in school/parish activities. Such photographs or video records may be used by staff and participants to remember the activities or participants. In addition, such photographs and audio/visual recordings may be used in Holy Family School publications or advertising materials to let others know about our school/parish. In addition, local news organizations may hear of our activities or events, and our school/parish may invite or allow them to photograph or record our events to be used, distributed, or displayed as agents of the school/parish see fit. This consent includes but is not limited to: photographs, videotape, and audio recordings. Children’s Names ____________________________________     Grade: ______ ____________________________________     Grade: ______ ____________________________________     Grade: ______ ____________________________________     Grade:______ Signatures of Parent/Guardian:               ______________________________________   ______________________________________ ______________________________________ Printed name of Parent/Guardian   Date: __________________________           ______________________________________ Printed name of Parent/Guardian Date: ________________________________