Pinellas County Schools

PARTICIPATING IN THE THEATRE PROGRAM

Thank you for taking the time to visit our site and fill out this form.

**Please note that if you participate in ANY other after-school activity you will need some of these forms so it would be advisable to make a copy of these forms.***

HERE IS WHAT YOU NEED

The following forms are online and need to be filled out.  Remember there are THREE separate forms that must be submitted. 

1. Field Trip/Activities Permission Form

• Just to be safe and to make sure we are always covered so we require both the PCS form AND the athletic permission slip to be filled out.

2. High School Activities Participation Form

• Yes, this is another permission slip, but it covers a few different items. This is necessary in case you get hurt or need medical attention for any reason.
  Keep in mind this is primarily meant for athletics so don't get scared when you read it.
• If you also play a sport, you've likely filled this out and turned it into your coach.  Please fill this out online for us so we have it for our records.  Thank you.

3. Media Release

• We will publicize in any possible way that we can. Often times that means contacting a TV or radio station, a newspaper or putting something online. The media release allows us your permission to use your son or daughter when those times come up

4. Student Insurance

• This is NOT included in this packet as it must be completed ONLINE
• Go to the school insurance page on this site or to pcsb.org/studentaccidentinsurance
• You can purchase whichever policy you’d like, but the least expensive one is fine.
• Once it’s purchased, you’ll get an email confirmation. Save that confirmation a PDF or JPEG and upload it on the site.

Again, without these forms, a student CANNOT stay after school for ANY reason with ANY club or sport

During the school year, Pinellas County Schools may produce, reproduce, broadcast or publish student names, likenesses and/or voices on multiple media formats, including but not limited to:

• WPDS-CH.14
• Written publications
• District websites
• School websites
• Teacher websites
• Social Media Sites
• Marketing Materials

All documents on district-sponsored websites are required to conform to school board policies, including Policy 7.33, Use of Electronic Resources.

In addition, news media, including representatives of television, radio, newspaper, and magazines, are periodically permitted on school board property and may take notes, still photographs, sound recordings, and/or videos that may include your child. These items may appear or be used in news or feature stories by print, television, digital, or radio media.

Pursuant to Section 540.08 and Section 1002.22, Florida Statutes, the school board is required to obtain express written permission before using any student’s name or likeness in the above-described manner. If you do not object to the use of your child’s name, picture, or voice for any purpose mentioned above, please sign the form below granting your consent pursuant to Section 540.08(1) and Section 1002.221(2a), F.S. If you have any questions, please contact the principal of your child’s school.

If the student or parent/guardian wishes to rescind this permission, he or she may do so at any time with written notice. Unless rescinded, this permission will remain in effect in subsequent years.

I grant permission to use the above student’s name, likeness and/or voice in the manners described above.

To submit the form

• Click the "Submit" button below
• Remember it is NOT turned in until you hit the submit button!!
• You MUST click the submit button! Once you hit submit you're done!  No need to turn in a hard.
• Don't forget though, you need to submit all THREE forms :)

View the completed PDF

• Click the "Preview PDF" button below
• Click Submit then on the next page click the "download completed PDF" button.
• It is HIGHLY suggested that you download a copy of the completed PDF for your records.

PCS Form 1-3067 (Rev. 5/21) Review Date 5/22