Minor Model/School Media Form
Only complete this form if you DO NOT want your child's photo used in media and marketing
If you DO NOT want your child to be a part of video or photography used in media, marketing, or press releases for Liberty Classical Academy, please fill out and sign this form
Name of Minor(s) (Printed) and Grade(s):
Your answer
Guardian's Name (Printed):
Your answer
Your answer
My child(ren), named above, may not have his or her photo taken or be videotaped:
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