Lafayette HSA 2018-19 Media Release
Lafayette's HSA loves to share photos of our students learning and playing, but we need your permission! Please read this form then either print out, sign, and return it to the HSA mailbox at school or sign digitally with your initials and submit. We will never use a child's full name with any photo.
Email address *
Note: You will need to submit a separate form for each child enrolled at Lafayette.
Student Name: *
Your answer
Student Grade 2018-19: *
I am the parent or legal guardian of the above-named child and authorize the Lafayette Elementary Home and School Association ("Lafayette HSA") to use photos of my child, his or her written work, and/or his or her artwork in publicly available materials including the Lafayette website, emails, and social media posts. I understand that my child's full name will not be included alongside any photo. I release the Lafayette HSA and its members from any legal claims or liability associated with such use. *
Please either sign using your initials and date below, or print out, sign, and return it to the HSA mailbox in Lafayette's front office.
Parent/Guardian Name *
Your answer
Parent/Guardian Signature (if submitting in hard copy) or Initials (if submitting digitally) *
Your answer
Today's Date *
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Phone number (Optional)
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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