Simple Release Form - Shouren Chinese School

守仁中文學校

SHOUREN CHINESE SCHOOL

P.O. Box 6846 Albany, CA 94706

Photo/Video Release Form

Name of Student 學生姓名 (please print):

Last Name ___________________________ First Name ___________________________

I hereby give permission of my child’s images through photographs, videos and all other forms of

media to be used solely for the purposes of Shouren Chinese School in promotional materials,

publications, and waive any rights of compensation or ownership thereto. I also release Shouren

Chinese School and its faculty members, employees and volunteers from all claims, demands and

liabilities whatsoever in connections with the above.

Name of Parent/Guardian (please print): ___________________________________________

Parent/Guardian’s Signature: ____________________________________________________

Date:__________/___________/___________

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Parent category: Legal