EDUCATIONAL SERVICE DISTRICT 112 Elevate 2026
  • EDUCATIONAL SERVICE DISTRICT 112

  • MEDIA RELEASE CONSENT FORM

  • ("Participant") grant to Educational Service District 112 ("ESD 112") the absolute and irrevocable right and unrestricted permission concerning any photographs taken of me and/or my property on this date of April 23, 2026 for Elevate Youth Summit to use, reuse, publish, and republish the photographs in whole or in part, individually or in connection with other material, in any and all media now or hereafter known, including the internet, and for any purpose whatsoever, specifically including illustration, promotion, art, editorial, advertising, and trade, without restriction as to alteration.

  • I hereby waive any right to approve the use of these photographs now or in the future, whether the use is known to me or unknown, and I waive any right to receive any royalties or other compensation related to the use of these photographs.
  • I have read and approve this Media Release Consent Form. I understand that I am free to contact ESD 112 with any questions regarding this Media Release Consent Form.
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  • ***Parent/Legal Guardian consent if Participant is a minor (under the age of 18)***

  • I certify that I am the Parent or Legal Guardian of the above named Participant and I consent to my child's participation and agree to this Media Release Consent Form.
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