The San Mateo Union High School District

Student Photo Release Form

As an integral part of the San Mateo Union High School curriculum,

teachers and staff members will, from time to time, use technology
within the learning environment. Videotapes, iMovies, still photographs,
and web pages are options available to teachers with in the context of
the curriculum. Most often, this is done to enhance a lesson, or
to share with parents and other classes. Occasionally students may
be photographed for a local newspaper articles or for SMUHSD
school newsletters. Videotapes of special events and ceremonies may also
be with the local cable station. Additionally, with the school
website and school brochures, student images may be displayed or
printed
Our desire
to promote
is that allthe
students
San Mateo
will be
Union
ableHigh
to participate
School District
in these activities,
and are seeking your permission for such use. If you have any questions
about this form please contact the principal of your student’s school.

Please check the appropriate box

below :
Yes, I here by give the unqualified right to the San Mateo Union High School
District to
take pictures and film of my child to put to legitimate use without limitation
or reservation.

No, I do not give the San Mateo Union High School District permission to take
pictures and film of my child.
Parent or Guardian Signature _____________________

Date___________________
Student’s Signature__________________________ Date___________________

Please Print Name_______________________ Date____________________