Video Tape & Photograph

VIDEO TAPE & PHOTOGRAPH

PERMISSION FORM

Date: ______________

Dear Parent:

We would like to request your permission to video tape and photograph your child during the year to be used in making a portfolio, to share with other educators regarding multi-district programs, in the newspaper, the Cooperative’s newsletter, and website for presentations explaining our programs and/or in recording activities for our classroom photographic albums. These photographs will sometimes be used on bulletin boards or will be sent home to parents.

My child, ________________________________

¨ May be video-taped and photographed.

¨ May be identified by his/her full name.

¨ May not be video-taped and photographed.

¨ May not be identified by his/her full name.

Thank you in advance for your consent regarding video-taping and photographing your child.

Sincerely,

________________________________________ __________________________________

Classroom Teacher Date

________________________________________ __________________________________

Signature of Parent/Guardian Date