Parent P ermission F orm
For P hoto a nd S tudent W ork P ublication
Metro-‐East W eb A cademy
Name o f S tudent _ ________________________________________
As p art o f o ur o utreach p rogram h ere a t G resham-‐Barlow W eb A cademy, w e a re a dding c lass p ages, s tudent w ork, a nd
student p hotos t o o ur w ebsite, ( located a t
w
), t o b rochures, f lyers a nd o ther d isplays b oth
inside a nd o utside o f t he s chool. I n o rder t o p ublish y our s tudent’s a rtwork, w riting o r p hoto, w e n eed t o h ave p arent o r
legal g uardian p ermission.
These g uidelines w ill b e f ollowed:
No p ersonal i nformation a bout s tudents, s uch a s l ast n ame, h ome a ddress o r t elephone n umber w ill b e p ublished.
All s tudent w ork a nd/or p hotos w ill a ppear w ith a c opyright n otice p rohibiting t he c opying o f s tudent w ork a nd/or
photos w ithout e xpress w ritten p ermission.
If a nyone s hould r equest s uch p ermission, t hose r equests w ill b e f orwarded t o t he c hild a nd t heir p arent/guardian.
The c opyright o f t he w ork w ill s till b elong t o t he s tudent.
I u nderstand t hat m y s tudent’s a rtwork, w riting a nd/or p hoto w ill b e c onsidered f or p ublication o n t he W orld W ide W eb
(a p art o f t he I nternet), i n b rochures, f lyers, a nd d isplays b oth i n t he s chool a nd o utside t he s chool.
Yes No I g rant p ermission f or t he p ublishing o f m y s tudent’s p hoto,
artwork, a nd w ritings, b ased o n t he g uidelines l isted a bove.
Please c heck e ither Y es o r N o f or a ll o f t he f ollowing
My S tudent’s A rtwork
My S tudent’s W riting
My s tudent i n a p hoto – e ither i ndividual o r g roup
Parent N ame ( printed): _ _______________________________
Parent S ignature: _ _____________________________________
Date: _ _____________
I, t he s tudent, a lso g ive m y p ermission f or s uch p ublishing.
Student S ignature: _ _____________________________________
Date: _ ______________