• STUDENT MEDIA CONSENT AND RELEASE FORM

    Dulles High School National Honor Society
  • I,       , parent/legal guardian of         grant permission to Dulles High School National Honor Society, hereinafter known as “NHS” to use my child's image (photographs and/or video) for use in NHS publications including, but not limited to: 

    - Videos, Email Blasts, Recruiting Brochures, Newsletters, Magazines, General Publications, Website and/or Affiliates 

    I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the 
    use of the image. 

    Please initial the paragraph below.

        - I am the parent or legal guardian of the below named child. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release. 

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