Photography Release Form

Required

St. James Episcopal School

Photography Release

Your child may be photographed at St. James Episcopal School during normal school hours or at other school-sponsored activities. These photographs may be used in promoting St. James Episcopal School or St. James Episcopal Church in print or on the internet.

Child's Namerequired

First Name

Middle (optional)

Last Name

Name your child goes byrequired

First Name

Last Name

Street Addressrequired

Cityrequired

Staterequired

Zip Coderequired

Name of person filling out this form:required

First Name

Last Name

Relationship to child:required

PLEASE SIGN ONE OF THE STATEMENTS BELOW, BUT NOT BOTH.

I give permission for my child to be photographed, or their images recorded for print or electronic use in promoting the St. James Episcopal School or Church. I understand it is my responsibility to update this form in the event I no longer wish to authorize the above use. I agree this form will remain in effect during the term of my child's enrollment. I understand there will be no payment for me or my child's participation.

Signature for permission to photograph:

Date

Must contain a date in M/D/YYYY format

I do not give permission for my child to be photographed.

Signature:

Date

Must contain a date in M/D/YYYY format