Page 1

Parent Permission Form For Photo and Student Work Publication Metro-East Web Academy Name of Student _________________________________________ As part of our outreach program here at Gresham-Barlow Web Academy, we are adding class pages, student work, and student photos to our website, (located at, to brochures, flyers and other displays both inside and outside of the school. In order to publish your student’s artwork, writing or photo, we need to have parent or legal guardian permission. These guidelines will be followed: No personal information about students, such as last name, home address or telephone number will be published. All student work and/or photos will appear with a copyright notice prohibiting the copying of student work and/or photos without express written permission. If anyone should request such permission, those requests will be forwarded to the child and their parent/guardian. The copyright of the work will still belong to the student.

I understand that my student’s artwork, writing and/or photo will be considered for publication on the World Wide Web (a part of the Internet), in brochures, flyers, and displays both in the school and outside the school. Yes

No I grant permission for the publishing of my student’s photo, artwork, and writings, based on the guidelines listed above. Please check either Yes or No for all of the following My Student’s Artwork My Student’s Writing My student in a photo – either individual or group

Parent Name (printed): ________________________________ Parent Signature: ______________________________________

Date: ______________

I, the student, also give my permission for such publishing. Student Signature: ______________________________________

Date: _______________

Photo and student work publication permission form