C.S. Lewis Academy Photo/Name Release
C.S. Lewis Academy occasionally publishes pictures and videos of students involved in school activities. Publications may include school newsletters, brochures, flyers, newspaper ads, the C.S. Lewis Academy website, CSLA social media sites such as Facebook and Twitter and other promotional materials.

Student recognition programs, academic programs, and fine arts programs are additional examples of activities that allow us to showcase our students. Highlighting the achievements and celebrating the successes in our school is an integral part of responsible reporting to our internal and external community.

However, it is our goal to respect your privacy as well. Therefore, parents/guardians are requested to indicate their wishes regarding CSLA's use of student photographs, videotapes or images.


POLICY CLARIFICATIONS:
• C.S. Lewis Academy will only utilize full name for INTERNAL (current parents, staff & faculty) documents, typically recognizing students' art work, or recognition for honor roll, school awards or other honors.
• It is school policy that any picture or video of a student published in EXTERNAL school publications, including the school website and social media accounts, not include full name (first names only), unless specific parent permission is given.
• Some of these pictures or videos may be action or candid shots taken during participation in an event. Other pictures or videos may be staged for specific purposes.


EXCEPTIONS:
*Photographs, videos or images including four or more students, without individual identification, are exempt from this policy, (i.e., groups in Chapel, Outdoor School or other events, or Team Photos).
*Annual School Yearbook
*High School Performing Arts or Athletics photos or recognition
*Media Releases regarding Senior HS students and their accomplishments
*C.S. Lewis Academy HS Commencement

Permission for these exceptions can be revoked only by special written request.

This form needs to be completed each year.

Please complete the form below. When applicable, we ask for both parents'/guardians' signatures.

Email address *
*
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If you answered yes above, but have exceptions to that answer, please note them here:
Your answer
Student 1 Name *
Your answer
Student 2 Name
Your answer
Student 3 Name
Your answer
Student 4 Name
Your answer
Mother or Guardian Signature: By typing your name in the signature box and clicking submit at the end of this document, you agree that you are electronically signing this agreement in accordance with the Electronic Signatures Act (Public Law No: 106-229), and agree to be bound by all terms and conditions. (type name)
Your answer
Father or Guardian Signature: By typing your name in the signature box and clicking submit at the end of this document, you agree that you are electronically signing this agreement in accordance with the Electronic Signatures Act (Public Law No: 106-229), and agree to be bound by all terms and conditions. (type name)
Your answer
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