2017 Media Consent Form
Media Consent:
Houston County High School band students will occasionally have photographs and video taken for use in various published material including yearbooks, newsletters, video, television, website, and social media. These photos will be used to advocate for music education, to highlight the activities and accomplishments of our students and to publicize and promote the Houston County High School Black and Silver Brigade.

I give my consent to have my child’s picture used in publication materials and to have their image presented in visual media promoting the Houston County Black and Silver Brigade. I grant to Houston County High School Black and Silver Brigade, its agents, licensees, and assigns the right to use my child’s likeness, photographic prints, sound reproductions, performance appearances while attending any band event for promotional purposes. I understand I will not be paid any royalties or other compensation. By granting these rights, I release Houston County High School Black and Silver and its agents, licensees, and assigns from all claims, liabilities, and/or damages which may arise from such use.

Untitled Question
Required
Parent Signature (by typing your name below, you consent to the above choice):
Your answer
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms