Conversayer Media Release Form

Dear Parent/Guardian:

Your student recently created a podcast recording as a class assignment. We want to recognize your student for a job well done by showcasing the recording on the Conversayer website. We may also post it on the Conversayer YouTube Channel.

Conversayer is a project to help students develop their digital communication skills using tools they’re already familiar with - smartphones, tablets, laptops and web apps.

If you'd like you student's recording published on Conversayer, please complete and submit this media release form. Thank you!

Name of Student*

Name of School*

Name of Teacher*

Class Title*

School Term*

My student's name may be published on the Conversayer website*

In full as shown aboveFirst name and last initial onlyDo not publish my student's name

a. I, as a parent or guardian, of the above named student fully authorize and grant the publication of my student's classroom recording on the Conversayer website (conversayer.net).

b. I understand and agree that use of the recording will be without any compensation to the student or the student’s parent or guardian.

c. I understand that I can request to have the recording removed from the Conversayer website at any time, and that the recording will be removed with 48 hours of the request. Request must be sent via email to martin@conversayer.org

d. I understand that Conversayer is not affiliated with my student's school district.

My signature shows that I have read and understand this release and I agree to accept its provisions.

Full name of Parent/Guardian*

First NameLast Name

Your email address is required for verification and notification.

Email*

example@example.com

Signature of Parent/Guardian*

Student Showcase Media Release