Media Release Form
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1Photograph/Video Release Form
Photograph/Video Release Form
To Parents and Guardians:
The New Covenant Preschool would like to take photographs and/or videos of the children
The New Covenant Preschool would like to take photographs and/or videos of the children
The New Covenant Preschool would like to take photographs and/or videos of the children to
illustrate learning activities in our
illustrate learning activities in our facility to publish on our website, in newsletters, promotions,
newsletters, promotions,
and news releases for the preschool.
for the preschool.
Before taking and publishing any photographs or video of your child, we need your permission.
any photographs or video of your child, we need your permission.
any photographs or video of your child, we need your permission.
Please review the options below,
review the options below, then sign and date where shown. Please return this form with
here shown. Please return this form with
your enrollment information.
Permission to Use Photographs and Videos
Permission to Use Photographs and Videos
__________I give The New Covenant Preschool my permission to use my child’s
I give The New Covenant Preschool my permission to use my child’s photograph/
I give The New Covenant Preschool my permission to use my child’s
video to illustrate educational activities
to illustrate educational activities in publicity materials produced by The N
New Covenant
Preschool, including printed publications and The New Covenant Preschool website. I hereby
printed publications and The New Covenant Preschool website. I hereby
printed publications and The New Covenant Preschool website. I hereby
release and discharge The New Covenant Preschool from any and all claims arising out of the
release and discharge The New Covenant Preschool from any and all claims arising out of the
release and discharge The New Covenant Preschool from any and all claims arising out of the
use of the photographs/videos that I or my child may have in this regard.
that I or my child may have in this regard.
No Permission to Use Photographs and Videos
se Photographs and Videos
__________ I do not give The New Covenant Preschool my permission to use my child’s
I do not give The New Covenant Preschool my permission to use my child’s
I do not give The New Covenant Preschool my permission to use my child’s
photographs/ videos to illustrate educational activities in
to illustrate educational activities in any publicity materials produced by
publicity materials produced by
The New Covenant Preschool, including printed pub
The New Covenant Preschool, including printed publications and The New Covenant Preschool
lications and The New Covenant Preschool
website.
Name of Child:_____________________________
____________________________________________________________
_______________________________
Name of Parent/Guardian (please print):_______________________________________
Name of Parent/Guardian (please print):_______________________________________
Name of Parent/Guardian (please print):_______________________________________
Parent/Guardian Signature: __________________
_________________________________________________
____________________________
Address: __________________________
________________________________________________________________
______________________________________
Phone Number:___________________________________________________________
Phone Number:___________________________________________________________
Phone Number:___________________________________________________________
Date:__________________________
Date:__________________________
_____________________________________________
_________________________
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