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 I understand my child's full name will not be published alongside their image without my separate okay, and that I may withdraw this permission at any time by writing to the school office.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

Child's full name

Age

Grade

Teacher / homeroom

Where photos may be used

School website

Social media

Newsletter

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.

Permission good through

Parent / guardian name

Relationship to child

Parent / guardian signature

Date

Phone or email

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