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McConnell
Middle School
Media
Release Form
Printable
Version of Media Release
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Student Name ______________________________________
Grade:____________
Homeroom Teacher: _________________________________
McConnell Middle School may develop, participate in, or be the subject of
media-based presentations and events which highlight various educational
activities that take place during the course of the school year. These
presentations/events are of two types
- Those developed by
McConnell students, McConnell staff, GCPS personnel and/or commercial
enterprises. These may include but are not limited to
- photographs of
students and activities
- slide/tape
presentations
- videotapes of
students and activities
- computer generated
presentations which may incorporate scanned photographs and video
clips
- computer based productions
transmitted via telecommunications
- These media based
presentations may be used in
- faculty
inservices
- parent programs
- staff development
activities
- media festivals
(local, state and international)
- public
relations
- newspaper
articles
- TV presentations
- McConnell Approved
Internet web pages
Check ONE:
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I hereby GIVE my permission to McConnell
Middle School to publish my child's presentations (as listed above) in
any of McConnell's or Gwinnett County Public School's media-based
productions for the above stated purposes.
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I hereby DENY my permission to McConnell
Middle School to publish my child's presentations (as listed above) in
any of McConnell's or Gwinnett County Public School's media-based productions
for the above stated purposes.
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Parent/Guardian
Signature:______________________
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Date:
___________
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(Note:
Professional media presentations may require additional release)
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