Last Name/First Name
For Choir, Drama, Art, and Band
2013-2014
During the school year several
members of the EVHS Fine Arts department will take photos or pictures of
student activities and events. In
addition to using these photos, names, for student publication purposes, the
EVHS Fine Arts Staff would like to use the photos for the various department
blogs and websites, the school website, programs, advertisements, etc. Please read and submit the following form to
Mrs. R, Mr. Roach, Ms. Waldron, Ms. Meadows, or Mr. Walker by Friday, September 6th,
2013. If you have any questions, please
email Mrs. Richtarski (EVHS Fine Arts Chair) at trichtar@culpeperschools.org or
call 540-825-0621 ext. 2335.
Thank you for your attention
to this matter,
Tiffany Richtarski
EVHS Fine Arts Chair
The undersigned
hereby consents to be used by Eastern View High School Fine Arts Program my
son/daughter’s name, likeness, picture, photograph, or quotation in all forms
and manner for educational, instructional, advertising, or promotional purposes
without consideration of the undersigned.
I herby wave my right to inspect or approve the finished version of any
written copy that might be used in connection with the Eastern View High School
Fine Arts Program. I agree to let my
son/daughter participate in these projects /photos etc. without financial remuneration
and understand that this releases The Eastern View Fine Arts Program from any
future claims as well as from any liability arising from use of
photograph/interview/quote/video recording/etc.
Name of Student:
_______________________________________________________________
Grade:
________________________Choir:___________________________________________
Parent /Guardian
Name:____________________________________________________________
Parent/Guardian
Signature__________________________________________________________
