Emergency Contact Sheet Page 4

High School Law Institute

NYU School of Law

Vanderbilt Hall

40 Washington Square South

New York, NY 10012

I hereby give my permission to New York University to use photographs or videos in

which my child’s image appears and my creative efforts including stories and artwork for

all purposes and in all media including, without limitation, brochures, advertisements and

other promotional materials. I understand that the High School Law Institute will do its

best to ensure that my child’s name will not appear with my child’s image, unless I

expressly give permission.

Student Name

Parent Name

Parent Signature

Date

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