| RELEASE FORM FOR ELECTRONIC DISPLAY OF PERSONAL INFORMATION | |
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Walnut Springs ISD is currently developing a web page for Internet publication. Please return this form as soon as possible to the school. Not only does it affect your student, it will also affect the publication of a group photo that your student may be in. Without this form no information about your student will be placed on the web site. |
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I, __________________________________________, give my permission for certain personally identifiable information about my child or a photograph of my child to be electronically displayed and produced by the District. |
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The following information MAY be displayed
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| _____Photo(individual) | EX. Photo of child as “speller of the week” etc |
| _____Photo(class or organization) | EX. As part of a football team, FFA, 4-H, class field trip |
| _____Name (first or last, but not both) with picture | EX. Shown are Bob, Sue, Sally, Jim |
| _____Name, no picture | EX – Band members include B. Smith, E. Smith, Jones, Hammond, |
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OR |
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| _____ No information of any type may be displayed pertaining to my student at Walnut Springs ISD | |
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Name of student to which this form pertains: |
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| Student Name______________________________________________ grade________________ | |
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Signature of student's parent ________________________________________________ |
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| Home address ___________________________________________________________ Date _______________ Home phone number ________________________ | |
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RELEASE FORM FOR THE ELECTRONIC DISPLAY OF ORIGINAL
WORK
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I, ____________________________________, give my permission for my / my child's work to be electronically displayed and produced by the District. |
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The work to be displayed is:___________________________________________________ _________________________________________________________________________ |
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Student's or employee's signature ____________________________ Date ____________ |
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Signature of student's parent ________________________________________________ |
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Home address _______________________________________________________ Date __________________ Home phone number ________________________ |