2019-2020 ARTLINK TEACHER'S HANDBOOK ENGLISH 2019 2020 ArtLink Guidelines FINAL | Page 77

CONSENT TO PHOTOGRAPH, FILM, OR VIDEOTAPE A STUDENT FOR NON-PROFIT USE
Student Name: _________________________ School: ______________________________________
Creative Connections periodically receives attention from newspapers, magazines, radio and TV
stations, asking to take pictures, do interviews and audio and video record portions of our
programs. This exposure is of great benefit to Creative Connections as a whole and brings
awareness for global competency and cultural education.
We need legal permission to do these things and ask you to read and respond to the information
below. Creative Connections understands the need to safeguard children who are included in the
photographs, which means that contact information of the children will remain confidential.
Creative Connections will never include the full name of the child alongside an image.
I hereby consent to participation in interviews, the use of quotes, and the taking of photographs,
movies, video and/or audio tapes of the student named above by Creative Connections.
I also grant the right to edit, use, and reuse said products for non-profit purposes including use in
print, on the internet, and all other forms of media. I also hereby release Creative Connections
and its agents and employees from all claims, demands, and liabilities whatsoever in connection
with the above.
Signature of Parent/Guardian (if student is under 18): _______________________________________
Date: _______________
Address of Parent/Guardian: ____________________________________________________________
OR
Signature of Student (if 18 or over): ______________________________________________________
Date: __________________ Address of Student: ____________________________________________
Contact Email: ________________________________________________________________________
Mathews Park • 303 West Avenue, Norwalk, CT 06850 USA • 203.803.4376 • CreativeConnections.org
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2019 -2020 ArtLink Program “Our Environment, My Culture”
Page 77