Lebanon Catholic School

2006-2007

Parental Waiver Form

I do NOT give my permission for photographs, videos and/or slides to be taken of _____________________________________

(Pupil’s Name – Grade)

while participating in school programs and/or activities.

No photographs, videos and/or slides may be used for brochures, presentations to parents and other interested groups, and for public relation purposes.

This paper must be signed and returned to Lebanon Catholic by September 30, 2006.

The school is not responsible for actions taken after this date.

_____________ ________________

Date Parent/Guardian Signature