Cobb County School District "Blanket" Permission To Participate Form/medical History Permission And Release Form/etc. Page 4

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NW Metro Atlanta Habitat for Humanity
A community with a passion for learning!
PERMISSION TO DISPLAY STUDENT PHOTOGRAPH/NAME
I hereby grant permission to Cobb County School District (District) to use or publicly display my child’s photograph,
video image, or audio clip on the District’s Web site(s), individual school
Web pages, or in other official District publications without further notice. I acknowledge the District's right to crop,
edit, or treat the photograph, video, or audio clip at its discretion.
I also understand that once my student’s photograph, video image, or audio clip is published on a Web site, it can be
downloaded by any computer user, on or off campus. I understand a student’s name may be published along with the
student’s picture.
Therefore, I agree to indemnify, defend and hold harmless the members of the Cobb County Board of Education, the
District, its officers, employees, agents, successors and assignees (the "Indemnified Parties") from and against any and
all claims and liabilities resulting from this publishing.
Subject/Nature of Event: Walton Habitat for Humanity Meetings, Fundraisers, and Build Days,
Permission is granted for the use requested above.
NOTE:
This form must be signed by student if the student is 18 years of age or older.
Name of Student
Signature of Student
Date of Student Signature
Name of Parent/Guardian
Signature of Parent/Guardian
Date of Parent/Guardian Signature(s)
Page 4 of 7
Waiver/Release Form v4.2014

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