Photo Waiver Release Form

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Forms PTA

Photo Waiver Release Form

Purpose of the Photo Waiver Release Form

This form is used to provide or deny consent for the school to use photos or videos of students for various purposes, including school publications, promotional materials, websites, and social media. It allows parents or guardians to specify whether their child's image can be included in these materials.

Photo Release Consent:

By signing this form, I, the undersigned parent or guardian of the named student, acknowledge and agree to the following:

1. Consent to Use of Photos/Videos
I grant permission for the school to use photos and videos of my child for:

School publications, newsletters, and yearbooks
Promotional materials, including brochures and flyers
School and district websites
Social media platforms managed by the school
External media outlets, such as local newspapers and TV stations

2. Assumption of Responsibility
If the “do not” box is selected, I acknowledge that the school will make every reasonable effort to ensure my child’s image is not used in media. However, I understand that accidental use may occur, and I release the school from any liability in such cases.

3. Automatic Consent in Absence of Form
I understand that if this form is not returned to the school, it will be considered that consent for photo and video use has been granted.

4. Revocation of Consent
I understand that I may revoke my consent at any time by providing written notice to the school. The school will make every effort to honor this change moving forward.

5. Questions and Clarifications
Any questions or concerns regarding the school’s photo release policy or related issues can be directed to the Main Office at:

Address
Email
Phone Number

Please indicate your preference by selecting an option below and submitting this form:

I hereby allow the reproduction and publication of my child's photograph(s)

I do not allow the reproduction and publication of my childs photogtaph(s)

Please fill out student information below.

Student First Name: *

Student Last Name: *

Grade:

Please fill out parent or guardian information below.

Parent/Guardian Full Name: *

Parent/Guardian Phone Number: *

Parent/Guardian Email: *

By signing this agreement, I acknowledge that I am the parent or guardian of the student and am providing consent for the school to either include or exclude my child from any photographs or recordings. I understand that while the school will make every reasonable effort to comply with this request, it cannot guarantee exclusion from all media, particularly in public or group settings. I agree to communicate any changes to this preference in writing to the school.

Use the space above to sign your name