Permission To Photograph To Child Care Provider


Permission to Photograph
I, ________________________, give permission for ________________________ to
(Parent or Guardian name)
(Child Care Provider)
photograph my child, ________________________, for the following purposes:
(Child’s name)
(Please check one)
Type of Use:
Grant Permission
Decline Permission
Still Photographs:
Display in my personal scrapbook
Give photographs possibly containing your
child to current clients
Display in facility’s scrapbook or bulletin
boards, shown to current and prospective
Display still photos on child care website*
Post photos on child care’s Facebook
Give video to current parents
YouTube™ promotional video
Other (please list):
*Only first names and possibly last initials (in the event of two or more children with the
same first name) will be displayed on the facility website.
I understand that it is my responsibility to update this form in the event that I no longer
wish to authorize one or more of the above uses. I agree that this form will remain in
effect during the term of my child’s enrollment.
(Parent or Guardian signature)


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