We are sending you this parental consent form to both inform you and to request permission for your child‘s photo/image and personally identifiable information to be published on the NJSBA website and Facebook page.

As you are aware, there are potential dangers associated with the posting of personally identifiable information on a website since global access to the Internet does not allow us to control who may access such information. These dangers have always existed; however, we as schools do want to celebrate your child and his/her work. The law requires that we ask for your permission to use information about your child.

Pursuant to law, we will not release any personally identifiable information without prior written consent from you as parent or guardian. Personally identifiable information includes student names, photo or image, residential addresses, email address, phone numbers and locations and times of class trips.

If you, as the parent or guardian, wish to rescind this agreement, you may do so at any time in writing by sending a letter to the principal of your child‘s school and such rescission will take effect upon receipt by the school.

Check one of the following choices:

I/We GRANT permission for a photo/image that includes this student without any other personal identifiers to be published on the NJSBA website and Facebook page.

I/We GRANT permission for this student‘s photo/image and name to be published on the NJSBA website and Facebook page.

I/We DO NOT GRANT permission for photo/image that includes this student to be published on the school and or district‘s public Internet site.

Student‘s Name:

Student‘s Grade:

Print Name of Parent/Guardian:

Signature of Parent/Guardian:

Relation to Student:

Date:

Email:

Your session has timed out.

Click here to access the application.

Parental/Guardian Consent Form