Liberty University
School of Education
M.Ed. in School Counseling
Permission to Tape
(Child and Adolescent)
I,
, give my permission to
,
a student of Liberty University, to audio or video tape my child/adolescent to fulfill requirements
in the counselor education program in the School of Education at the university. I understand that
this tape will be used for instructional purposes, viewed/heard only by the site supervisor,
instructor, and students in the graduate course. I understand that after the tape has been reviewed,
it will be erased.
Signature of parent or guardian
Date