Release Form Washington Association For Language Teaching printable pdf download

WAFLT Release Form

I, the undersigned, hereby consent to the reproduction, use, publication, and/or exhibition by

Washington Association of Foreign Language Teachers. (“WAFLT”) of the image, voice, or written

contribution of the person named below, including but not limited to photographs, art work, film, video

recordings, and sound recordings. I further release WAFLT from any and all claims for damages for

defamation, libel, slander, invasion of privacy, or any other claim based on the use of the above-

described materials. The consideration for this release is other than money, the sufficiency and receipt of

which is hereby acknowledged by the undersigned. Neither WAFLT nor anyone associated with

WAFLT has made any promise of any other compensation in relation to this release.

• WAFLT may use the above-described materials in all manner of media: WAFLT FORUM

Newsletter, WAFLT International website, unrestricted use for purposes of education, publicity,

advertising, trade, display, editorial, exhibits, fundraising, and art.

Name ______________________________________________________________________________

Address ____________________________________________________________________________

City, State, Zip _______________________________________________________________________

Phone Number _______________________________________________________________________

Parent’s / Guardian’s Consent

The undersigned represents that he/she is the parent and/or guardian of the minor named above and

represents that he/she has the legal authority to execute the preceding consent and release and hereby

approves the preceding and waives any rights in the premises.

Name_______________________________________________________________________________

(Last name, First name and Relationship to student)

Signed __________________________________________ Date____________________________

Authorization for Release of Information/ Student’s Name Release:

I authorize the release of my son’s or daughter’s name on the image, voice, or written contribution of

the person named below, including but not limited to photographs, art work, film, video recordings, and

sound recordings.

Student’s Name (printed):_____________________________________________________________

Parent’s Name (printed): _______________________________________________________________

Parent’s Signature: ____________________________________________Date___________________

Release Form Washington Association For Language Teaching