Authorization and Permission for Photo/Videos

Authorization and Permission for Photo/Videos
Please select:*

Marie Philip SchoolWalden SchoolBadavas Parent Infant Program (PIP)Community ASL ClassesOther
I permit The Learning Center for the Deaf to use a picture or video of myself or my child for the purposes of brochures, newsletters, TLC web page, social media, and other media related to the marketing and promotion of TLC, the schools, and its activities.
Select One:*

YESNO
Student Name:*

First NameLast Name
Primary Parent/Guardian Name:

First NameLast Name
Primary Parent/Guardian Email:*
example@example.com
Should be Empty: