CONSENT TO PHOTOGRAPH, FILM, OR VIDEOTAPE A STUDENT FOR NON-PROFIT USE (e.g. educational, public service, or health awareness purposes)
Sign in to Google
to save your progress.
Student OSIS (ID)
I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or video tapes of the Student named above (enter the parent name below).
By checking yes below, I also grant William Cullen Bryant High School the right to edit, use, and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release the New York City Department of Education and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above.
Electronic Signature (please enter the name of the parent/guardian below as an electronic signature).
Enter today's Date
Never submit passwords through Google Forms.
This form was created inside of William Cullen Bryant High School.