The purpose of this consent form is to receive permission to use your child's picture on the River Valley School District's web site. Please be aware that information/pictures placed on the district's web site can be accessed world wide via the Internet.
I consent to the district using my son's/daughter's picture, with or without name included, on the River Valley School District web site. I understand that my child's first and last name may be included with the picture.
Student’s Name (please print)
___________________________________________________________
Parent/Guardian Signature or Student’s Signature (if student is age 18)
___________________________________________________________
Date
_______________________
Approved: May 4, 2000
12/21/2004 pw