Important Notice for Parents And/Or Guardians

DATE

IMPORTANT NOTICE FOR PARENTS AND/OR GUARDIANS

MEDIA CONSENT FORM

for the INSIDE OUT: Stories of Identity Project

In accordance with the Freedom of Information and Protection of Privacy Act, the Vancouver Board of Education is seeking your consent to take, retain, use and disclose photographs, videos, images and/or names of students and groups of students for the district’s INSIDE OUT: Stories of Identity project.

The INSIDE OUT: Stories of Identity project will invite elementary and secondary students to share their lived experiences and the unique aspects of their identity of which they are most proud through writing and photographs. This project will use the power of storytelling as a means to bridge difference and understanding and to highlight the importance of diversity in the school communities across the district and beyond.

This project may include the following:

• The use of a student’s image or name to be displayed on district and/or school communications such as newsletters, brochures, newspapers, magazines, websites, VSB social media channels and reports;

• External media communications such as newspapers, television, radio or on-line publications, including media photographs and interviews for events relating to the project;

• Videos, CDs, podcasts, DVDs for educational use only

• Displaying student photographs on large public spaces in Vancouver

___ I DO give my consent for the school district to collect, use and publicly disclose my child’s name/image/school for purposes consistent with the above for this project. I understand that images posted on the internet may be stored and accessed from outside of Canada.

___ I DO NOT consent to the use and disclosure of my child’s image or name for the above purposes for this project.

Name of Student______

School______

Name of Parent/Guardian (please print) ______

Signature of Parent/Guardian______

Date______

For school purposes only:

Please retain this copy for your records.