2011-2012 Plano Independent School District
Release Form For Publications, Video, And Electronic Display Of Student Work

Students who attend school in the Plano Independent School District are occasionally asked to be a part of school and/or District publicity, publications and/or public relations activities. In order to guarantee student privacy and ensure your agreement for your student to participate, the District asks that you sign this form and return a form to the school for each of your students.
The form referenced below indicates approval for the student's name, picture, work, voice, verbal statements, or portraits (video or still) to appear in school publicity or District publications, videos or on the District's Web site. For example, pictures and articles about school activities may appear in local newspapers or District publications. These pictures and articles may or may not personally identify the student. The pictures, videos, and artwork may be used by the District in subsequent years.

AGREEMENT

Student and parent/guardian release to Plano ISD the student's name, voice, verbal statements, class assignment(s), portraits (video or still), pictures and artwork and consent to their use on behalf of Plano ISD for publicity purposes.

Plano ISD agrees that the student's name, work, voice, verbal statements, class assignment(s), portraits, or pictures (video or still) will only be used for public relations, public information, school or District promotion, publicity, and instruction.

Student and Parent/Guardian understand and agree that:

  • Consent and release have been given without coercion or duress;
  • This agreement is binding upon heirs and/or future legal representatives; and
  • The photo, video, artwork, class assignment(s) or student statements may be used in subsequent years.

If the Student and Parent/Guardian wish to rescind this agreement, they may do so at any time with written notice.

Effective Date of Agreement ________________________________

Student's Name (please print) ________________________________

Student's Signature ________________________________

Parent/Guardian Name (please print) ________________________________

Parent/Guardian Signature (please print) ________________________________

Pursuant to Texas Education Code, Section 26.009(b)(2)
PISD has no control of media use of pictures/statements which are taken without permission.