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WHS Student Media Consent and Release Form
Throughout the school year, students may be highlighted in efforts to promote WSD
activities and achievements. For example, students may be featured in materials to train teachers and/or increase public awareness of our schools through newspapers, radio, TV, the web, DVDs, displays, brochures, and other types of media.

I, as the parent or guardian of the student listed below, hereby give WSD and its employees, representatives, and authorized media organizations permission to print, photograph, and record my child for use in audio, video, film, or any other electronic, digital and printed media.

This is with the understanding that neither WSD nor its representatives will reproduce said photograph, interview, or likeness for any commercial value or receive monetary gain for use of any reproduction/broadcast of said photograph or likeness. I am also fully aware that I will not receive monetary compensation for my child’s participation.

I further release and relieve, WSD its Board of Trustees, employees, and other representatives from any liabilities, known or unknown, arising out of the use of this material.

I certify that I have read the Media Consent and Release Liability statement and fully understand its terms and conditions.

Please understand that failure to return this release form within ten (10) school days from the date of the distribution will constitute approval of the above requests.

Student's Name: *
Graduation year: *
By submitting this form, I acknowledge that I have read and understood the Student Media Consent and Release Form. Please type your first and last name and today's date. *
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