Religious School Permission for Publication of Photographs

Publication Permission Form
Beth Israel Hebrew School does not publish or provide for publication any personal information about its students without parental consent.

I give permission for photographs of my child or my child's work to be published by the Beth Israel Religious School, or provided for publication, without the identification of my child by his or her name in all media forms as appropriate to advance the educational and institutional mission of Beth Israel Congregation.

This authorization remains in effect until rescinded in writing or with an updated Publication Permission Form.
Student 1 Name*

First NameLast Name
Student 2 Name

First NameLast Name
Student 3 Name

First NameLast Name
I accept the term of this form.
Name

First NameLast Name
Date

MonthDayYear
Should be Empty:

Publication Permission Form