Consent & Release Form

I, _______________________________am the lawful parent or

guardian of _____________________________________, presently a

student at ___________________________________ and a minor. I hereby

grant permission for my child to be photographed or recorded in connection

with any activity my child is involved in while enrolled as a student in

__________________________________________.

I understand that the photographs and recordings may be used for

purposes including but not limited to public service announcements and

other programs and publications shown to the general public or used by the

media for news reports presented to the general public.

I understand that my execution of this Authorization serves a wavier

of privacy rights otherwise available pursuant to the Section 1002.22,

Florida Statutes, or other applicable law, with respect to the above described

events(s).

I understand that I may revoke this permission at any time.

_______________________________ ________________

Signature of Parent or Guardian Date