Chinese Heritage School of NJ (華仁中文學校) Photo Release (DO NOT CONSENT) 2017-2018 School Year
THIS FORM IS FOR GIVING NO CONSENT TO PHOTOGRAPHING, FILMING, OR VIDEOTAPING A STUDENT FOR NON-PROFIT USE. THIS FORM IS ONLY VALID FOR THE 2017-2018 SCHOOL YEAR AND WILL NEED TO BE RESUBMITTED EVERY SCHOOL YEAR SHOULD IT BE NEEDED.
Student Name: *
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Grade/Class *
I DO NOT grant permission for CHS (Chinese Heritage School) in the 2017-2018 school year to the use of the photograph(s) or electronic media images as identified below in any presentation of any and all kind whatsoever. I understand that I may regive authorization at any time by notifying CHS in writing. *
Required
Parent/Guardian Name: *
Your answer
Parent/Guardian Email: *
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Parent/Guardian Phone Number: *
Your answer
Parent/Guardian Signature (retype name as confirmation): *
Your answer
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