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    Dr. Diana Greene
    Superintendent
    1701 Prudential Drive
    Jacksonville, FL 32207
    904.390.2000
    www.duvalschools.org

    Student Media Release

     

    DCPS Productions or outside organization, including news media

     


    I , ____________________________________, hereby authorize the


    videotaping/filming/photography of my child, ______________________________,


    and/or the release of his/her name and achievement(s) for publishing (print,


    World Wide Web) and/or broadcasting purposes. I also consent to the showing


    of the video/film/photographs to any person. I understand that the Duval


    County School District is not a party to outside organizations’


    photography/filming/video production and will hold Duval County Public


    Schools and its employees harmless from any liability in connection with a


    production not produced internally by Duval County Public Schools.

     


    ___________________________________
    Signature


    ___________________________________
    Print Name


    ___________________________________
    Date

     

     

    EVERY SCHOOL. EVERY CLASSROOM. EVERY STUDENT. EVERY DAY.