Heritage Learning Center
Publication Release Form
Occasionally, HLC desires to display photographic images of our events and activities during the
school year on our school website, Facebook page and in official printed or electronic publications for
the school. The photographs used on the school website will be images of one or more of the
students participating in school activities and may contain images of your child and/or you. In order to
do so, we must have written permission from your for your child and/or yourself before we can publish
such items. Please fill out this form completely (the top portion for your child and the bottom portion
for you) if you wish to grant the school such permission to utilize your images as described above.
______________________________________________________________________________
Consent form for Student
I hereby give permission to HLC to use photographs of my child on its website or in other official
school printed or digital media without further consideration. It is my understanding that the
photographs used on the school website will be images of one or more children participating in school
activities of which my child may be a part of.
I also understand that once photos are posted on the school’s website and other electronic media,
images can be downloaded by any computer accessing the publication. Therefore, I agree to
indemnify and hold harmless the school and any photographer whose services are used by the
school whether paid or unpaid from any and all claims.
Date: ___________________________
Students Name (print): ___________________________________________________________
Name of Parent/Guardian (print): __________________________________________________
Signature of Parent giving permission: ______________________________________________
______________________________________________________________________________
Consent form for Parents/Guardians
I hereby give permission to HLC to use photographic images that contain me with my child on the
school website or other electronic media without further consideration.
I also understand that once photos are posted on the school’s website and other electronic media,
images can be downloaded by any computer accessing the publication.
Date: ____________________________________
Signature of Mother/Guardian: ____________________________________________________
Signature of Father/Guardian: _____________________________________________________