Consent to Photograph, Film, or Videotape a Student for Non-Profit Use
Student's First and Last Name *
Class *
School *
I 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 by P.S./I.S. 192. *
I also grant to P.S./I.S. 192 the right to edit, use, and reuse said products for non- profit purposes including use in print, on the internet, and all other forms of media. *
I also hereby release the New York City Department of Education and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above. *
Parent's First and Last Name *
Date *
Parent or Guardian's Address *
Never submit passwords through Google Forms.
This form was created inside of NYC Department of Education. Report Abuse