Media Consent Form (2021-2022)
CONSENT TO PHOTOGRAPH, FILM, OR VIDEOTAPE A STUDENT FOR NON-PROFIT USE
(e.g. educational, public service, or health awareness purposes)
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Student Name *
School name (2021-2022) *
School name (2020-2021 if different that 2021-2022) *
I , as the parent of the student listed above, 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. I also grant to the right to edit, use, and reuse said products for nonprofit purposes including use in print, on the internet, and all other forms of media. I also hereby release the American Debate League and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above. *
Parent's Name (completed by parent and serves as a signature) *
Parent's Email Address *
Parent's Phone Number *
School Principal's Name *
School Principal's Email *
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