Media Permission Form

E3 Academy

Please fill out the media permission form below. Ensure all student information and institutional policies are fully reviewed before submitting

School Media Release Form

Parent & Student Information

Parent or Legal Guardian Name *

Children Covered Under This Media Release

Student's Full Name *

Grade *

Media Release Terms & Conditions

I understand that E3 Christian Academy does from time to time record images and audio of students and their families during school hours and at school-related events. I understand that these may include video recordings, photographs and audio recordings. I hereby give permission for E3 Christian Academy to use the above-mentioned images and recordings of my child and my family to be stored digitally and in newsletters, yearbooks, brochures, and on the school's and the parent/teacher's websites for advertising, recruiting new students, distribution to parents from the school and other school-related purposes.

I confirm that I am the custodial parent or legal guardian and hereby authorize all conditions stated in this Media Release. *

Verification & Signature

Parent or Legal Guardian Signature *

Date Signed *

E3 Academy