Media Release Form

indicates a required answer

1. *

I consent to having my child's/children's photo(s), artwork(s), and achievements published in the Heritage Creative Arts yearbook, advertisements, and or website.
Agree Disagree
2. *

Please list your child/children(s) names, grade and age.
3. *

Name:
4. *

Signature:
By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.
5. *

Date:
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