CONSENT TO PHOTOGRAPH, FILM, OR VIDEOTAPE A STUDENT FOR NON-PROFIT USE (e.g. educational, public service, or health awareness purpose)
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Email *
Student's First Name: *
Student's Last Name: *
Class: *
Name of School: *
Consent: Please check one *
Parent/guardian please sign: By entering your initials on the line below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.   *
Parent/Guardian Address: *
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