LEARNING 4 LIFE FARM

I, the undersigned, do hereby grant or deny permission to The Learning 4 Life Farm to use the image of my child,, as marked by my selection(s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on The Learning 4 Life Farm website. Please initial all that apply and sign below.

Grant Permission: I agree that my child's image can be used for The Learning 4

Life Farm social media for the purpose of program awareness and outreach.

Deny Permission: I do not give permission for my child's image to be used in print,

video, and/or digital media of any kind.