Student Voice Recording Publication Consent Form
Please complete this form to provide consent for the publication of student voice recordings.
Student Information
Please provide details about the student whose voice recording may be published.
Student Full Name
*
First Name
Last Name
Student Grade/Class
*
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Other
School Name
*
Parent/Guardian Information
If the student is under 18, please provide parent or legal guardian details.
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Student
*
Please Select
Mother
Father
Legal Guardian
Other
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Voice Recording Details
Information about the recording and its intended publication.
Event or Activity Name
*
Date of Recording
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Purpose of Recording Publication
*
Please Select
School Website
Social Media
Promotional Materials
Educational Resources
Other
I hereby grant permission for the student’s voice recording to be published and used for the purposes described above. I understand that the recording may be shared publicly, and I release the school and its representatives from any claims arising from the use of the recording, as described in this form. I confirm that I am authorized to provide this consent.
*
Submit Consent
Submit Consent
Should be Empty: