Grades of Green - Consent & Permission Form
Congratulations on your student joining the this years Grades of Green of Programs! We are thrilled to have your student join us. Please complete this form with your student. Your permission is required for your student's participation. If you are a student that is 18 or older, please write N/A in questions related to a parent or guardian.
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Cell Phone Number
Parent/Guardian Email
*
example@example.com
You can contact me via...
*
Text or Phone
Email
Both
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Student Full Name
*
First Name
Last Name
Student's Non-school Email
*
Only to be used to communicate about Grades of Green Programs
Student Cell Phone Number
*
Student Cell Phone Number - Only to be used to communicate about Grades of Green Program
Which program is the student participating in?
*
LAUNCH Project Toolkits
RISE Climate Solutions Campaign
SOAR Green Eco-Innovation Academy
UNITE Global Sister School Network
Other
Other
Permission to Contact
*
Yes, Grades of Green may contact the student via Email and Phone/Text
Grades of Green may only contact the student via Email
Grades of Green may NOT contact students.
Student's School
*
Please write in this example format: Suzanne Middle School
School Location
*
California
United States (Outside California)
International (Outside United States)
Student's Grade level as of this Fall
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
HS Freshman
HS Sophomore
HS Junior
HS Senior
Other
Other Grade
Student's Age as of September 14
*
Demographics
Racial or Ethnic Identity
*
Native American/Alaska Native
Asian or Asian/Pacific Islander
Hispanic/Latino (Non-White)
Black/African American
White
Hawaiian Nat./Pacific Isl.
Two or More Races
Prefer to not disclose
Other
Other Race
Gender
*
Male
Female
Non-binary
Prefer not to disclose
Other
Other Gender
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Consent
My student can participate in Grades of Green's programs and events
*
I give consent for my student to participate
I do NOT give consent for my student to participate
Photo/Video Release Form
Permission to Use Photograph/Videotape from Grades of Green Programs and EventsI am the parent or guardian of this student (or a student over 18) and I grant to Grades of Green, Inc., its licensees, assigns, and transferees (collectively “Grades of Green”) the right to take photographs of my child in connection with Grades of Green's events and programs. I authorize Grades of Green to reproduce, distribute, exhibit, modify, broadcast, display, or otherwise use such photographs in all media now or hereafter known for any lawful purpose, including but not limited to, publicity, advertisement, website content, and educational illustration. I understand the term “videotape” as used in this Release includes both video and audio footage. I agree that Grades of Green may use such photographs of my child, with or without my child’s first and last name, and that I have no right of approval or claim of compensation over the photographs. I agree that I shall have no claim against Grades of Green arising out of the use of such photographs of my child, including but not limited to, claims based on invasion of privacy, defamation, or right of publicity. I hereby release and hold harmless Grades of Green from any and all liability arising from any activities authorized by this Release.
I have read and understand the above release and warrant that I have the authority to give such consent.
*
I give consent for Grades of Green to use images and/or representations of my child.
I do NOT give consent for Grades of Green to use images and/or representations of my child.
By submitting this form, I am acknowledging that I am the legal guardian of the student (or a student over 18) and have voluntarily completed this form.
*
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