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Science Fair Photo
Release Information
Student Information (Please Print):
Brevard Public Schools
Last Name:___________________________ First Name:_______________________
School:_______________________ Grade:______ Birthdate:____________________
Parent Information (Please Print):
Name(s)______________________________________________________________
Address:______________________________________________________________
City:________________________ Zip:__________ Telephone:__________________
n order to use a photograph of the student and/or her/his project at Science Fair in a
publication of any kind, or to use your image on any type of film, permission must be
granted in writing by you and your parent(s) or guardian(s).
Permission is hereby granted for photographs or films of student and/or her/his
project at Science Fair Competitions to be taken and publicized by vendors or the media
and Brevard Public Schools at the discretion of the Science Fair Directors.
Student signature:_________________________
Parent signature: ________________________________ Date:_______________
Permission is not granted for photographs
Student signature:___________________________
Parent Signature: ____________________________ Date:___________________
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2008-2009