GCMS PHOTO RELEASE FORM

GEM CITY MUSIC STUDIO

2100 E David Rd Dayton, OH 45440 | (937) 985-2226 gemcitymusicstudio@gmail.com | gemcitymusicstudio.com
PERMISSION TO PHOTOGRAPH OR VIDEO RECORD

By granting permission, you are allowing Gem City Music Studio to photograph and take video recordings of your child. Your child's picture/video will never be sold or used for purposes any other purpose without obtaining additional consent. You may revoke this permission in writing at any time.
Name of student(s) enrolled
Yes, I give permission for Gem City Music Studio to photograph or video record my child(ren) (named above) to be shared on Gem City Music Studio's website, Facebook page, newsletters and YouTube channel for educational purposes, advertising and to celebrate student achievements. This includes sharing videos from studio events such as Masterclasses. No, I do not give permission for GemCity Music Studio to photograph or video record my child(ren) (named above) tobe shared on Gem City Music Studio's website, Facebook page, newsletters andYouTube channel for educational purposes, advertising and to celebrate student achievements.This includes sharing videos from studio events such as Masterclasses.
Parent/Guardian (Print)
Parent/Guardian (Sign)

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