Printable Form

Web Permission Slip

Dear Parent or Guardin,

The parent consent form below is to inform you about web publishing and to request your permission for your child's photo/image and student work to be posted/published on the school's web site.

Student Consent Form for Posting to the Internet/St. Mary Web Site

Please complete this consent form and return to your child's Homeroom teacher.

 

Please put a check mark in the box/boxes to the left if you agree

 

I do grant permission for St. Mary School to use my child's photo/image that includes this student in a group without any personal identifiers to be published on the school web site.

 

 

I do not grant permission for St. Mary School to use my child's photo/image that includes this student in a group without any personal identifiers to be published on the school web site.

 

 

I do grant permission for St. Mary School to use this student's schoolwork (artwork, writing, projects, presentation, etc.) to be posted on the school's web site with no personal identifiers.

 

 

I do not grant permission for St. Mary School to use this student's schoolwork (artwork, writing, projects, presentation, etc.) to be posted on the school's web site.

 I am the parent or legal guardian of the student listed below and I hereby approve the foregoing consent to the use of school photos and published work to the pursuant terms mentioned above. I affirm that I have the legal right to issue such consent.

 

Student's name: (please print)

Parent/Guardian: (please print)

Relation to Student:

 

Signature of Parent/Guardian:

Date

 

 

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