AISD Photo and Video Release Form

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AISD Photo and Video Release Form
I do hereby grant to Austin Independent School District the unlimited right to use and/or reproduce photographs,
likenesses or the voice of my child in any legal manner and for the internal or external promotional and informational
activities of Austin Independent School District. I also agree to allow my child to be interviewed and/or photographed
by representatives of the external news media in relation to any and all coverage of Austin Independent School District
in which they are involved. I also agree to allow my child's work and/or photograph to be published on the Austin
Independent School District Web Pages and/or AISD publications. I further understand that by signing this release, I
waive any and all present, or future compensation rights to the use of the above stated material(s).
School Name __________________________________________________________________
Student's Name _____________________________________________
Parent/Guardian Signature __________________________________ Date ______________
Parent/Guardian Name (please print) ______________________________________________
Parent/Guardian Address _______________________________________________________
_______________________________________________________
THIS INFORMATION TO BE COMPLETED BY SCHOOL OFFICIALS ONLY.
Your Name__________________________________________ Date ____________________
Type of Material
 Photograph
 Videotape
 Voice Recording
 Other (please specify)
Use of Material
(Please provide additional information such as name of news outlet, brochure, purpose of presentation, etc.)
 News Outlet __________________________________________________________
 UCPS Internet/Intranet Site(s) ____________________________________________
 Brochure _____________________________________________________________
 PowerPoint Presentation ________________________________________________

Other__________________________________________________________
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