Media Permission Form

Child's Name*

First Last

Parent's Name*

First Last

Parent Email*

Release of Information

I grant St. James Parish Day School permission to photograph my child whose name is listed above while involved in school activities or participating in school functions on or off campus.*

Yes
No

I grant St. James Parish Day School permission to use these photographs in classroom only.*

Yes
No

I grant St. James Parish Day School permission to use these photographs in classroom newsletters, school newsletters or informational brochures*

Yes
No

I grant St. James Parish Day School permission to use photographs of my child on the schools website, social media pages and local newspaper groups.*

(When names are added only first name is used.)

Yes
No

I understand that I have the right to request, in writing, to have a photo removed from the website or Facebook within 30 days.*

Yes
No

I grant St. James Parish Day School permission to publish my families address, contact number, child’s name, parents names and email address in the School Directory.*

Yes
No

Please check the following.*

I am the parent of the above listed student and hereby authorize St. James Parish Day School to all the above listed items.

Parent Signature*

Please type your full name.