Photo Consent Form

Parent Name*

Please type the name of parent who filled this form. Thank you.

Parent Email*

Child's Name*

Grade*

Authorization*

I, (Parent or Guardian’s Name typed below) hereby consent to the participation in interview’s, the use of quotes and the taking of photographs, movies or video tapes of my son/daughter and his/her work by Congregation Emanu-El of Westchester.

I also grant to Congregation Emanu-El of Westchester the right to edit, use and reuse said products for non-profit purposes (e.g. educational, public service or health awareness purposes) and to post them on the temple website. I also hereby release Congregation Emanu-El of Westchester and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above.

Declining Consent?

I do not wish to give consent for use of my child's photographs or other recorded materials

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Photo Consent Form

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