Photo Permission Form

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Photo Permission Form
From time to time, members of the news media are invited to the Pre-K or
photos submitted. The photos may relate to a particular event or to a general
educational topic.
We are requesting your permission to release your child’s photograph, name,
and /or videotape for publication/airing during the ___________ school year.
This will be used for news or community interest only. Commercial use is
prohibited without prior approval.
We would appreciate your completing the form below. Thank you.
Student Name:__________________________________________________
□ I hereby give permission for the Montclair Community Pre-K to release
photographs, a class videotape and /or the name of my child to the
media. I understand this will not be used for commercial purposes.
□ I do not want my child’s photo, name or videotape used.
Signature of
Parent/ Caregiver________________________________________ Date_________________

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