Maplewood Elementary
Community School District

Student Photo Release

Parent / Guardian Permission
Permission to use my child's photo

I give Maplewood Elementary permission to photograph and record my child during school activities, and to use those photos and video to share and celebrate our school in the ways I've marked below. I understand my child's full name will not be published alongside their image without my separate okay, and that I may withdraw this permission at any time by writing to the school office.

About the child
Mateo Alvarez
8
3rd
Ms. Patterson
Where photos may be used
XSchool website
XSocial media
XNewsletter
Print & yearbook
Promotional materials
Local press
Opt out instead. Check this box if you do not want your child's photo used in any of the ways above. We'll make sure they're not included.
End of 2026–2027 school year
Carmen Alvarez
Mother
Carmen Alvarez
Parent / guardian signature
June 18, 2026

Maplewood Elementary · Community School District · Office: (503) 555-0172