Video Class Index

Parent Release Form

The participants who appear in the video are often called the actors, talent, or subjects. Consider the legal issues surrounding the use of location and talent. If minors are included in a video, a parent's signature on a permission slip is required. Adults should also provide written releases if the final project will be published on the web. The release should state the specific project for which the video will be used, explain how it will be distributed, and request a signature giving you permission to publish the products and likeness (images and video) of the participant. It may be useful to explain how privacy and safety issues are being addressed.

Dear Parent:

As a Certified Teacher, I will be presenting an enrichment class in videography at Premier High School during the 2008 - 2009 school year. This class will teach the fundamentals in capturing, editing and uploading video for our video library. Occasionally, there could be an opportunity for us to show our work in a public forum.

Most of our projects will result in video segments of me with students and the publishing of student developed projects in an educational arena. It is required that I only use students whose parents/legal guardians have consented in writing to have their child’s participate.

To protect their privacy, neither the video or web materials will include reference to their last name, home address, or phone number. Additionally, we will not publish the name of the child on any projects created.

Please sign below if you wish to give me permission to include your child in these projects.

With my signature below, I give permission for my child, ________________________ to have his/her likeness displayed in the form of video or still images and possibly, examples of learning materials produced by my child. I hereby release Ms. Leeson, the videography teacher and Premier High School, and Eagle Charter Schools from any and all liability and legal or equitable claims of any kind related to such work being published.

I understand that my child will be identified in video by first name only.

Student’s Name Printed _________________________________________________

Campus _____________________________________________________________

Parent/guardian Name Printed ____________________________________________

Signature ____________________________________________________________

To print this form, simply go to your browser menu and choose "file". Under file, you will see "Print". Also, there is another link here, that will mail the form directly to me. You can always forward a copy of the page to yourself by accessing "Send Page" offered in your browser menu.