St. James' Episcopal School
Photo Release Form
I give permission for my child to be included in photos/videos to be taken at various times and
events during the 2007/2008 school year. I understand that St. James’ Episcopal School may
use these photographs for print, web, or other public viewing media.
Your child's name:
Your child's teacher:
Address:
City:
State: VA
Zip:
Your name:
By checking this box, I hereby give consent for my child to be included in photographs/videos at St.
James' Episcopal School, and I understand that these photos shall be used for school purposes only,
via web, print, and other public media forums. This form replaces my handwritten signature.