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Parental Social Media Consent Form

This document is a parental consent form for the publication of a child's video/photo/image and personal identifiable information on social media and other outlets by an organization. It outlines the potential risks associated with sharing such information and emphasizes that no personal information will be released without written consent. Parents/guardians have the option to grant or deny permission and can rescind their agreement at any time in writing.

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seleman.sandi
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248 views1 page

Parental Social Media Consent Form

This document is a parental consent form for the publication of a child's video/photo/image and personal identifiable information on social media and other outlets by an organization. It outlines the potential risks associated with sharing such information and emphasizes that no personal information will be released without written consent. Parents/guardians have the option to grant or deny permission and can rescind their agreement at any time in writing.

Uploaded by

seleman.sandi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PARENTAL/GUARDIAN SOCIAL MEDIA CONSENT FORM

Organization Name: _______________________________________

This parental consent form is to request permission for your child’s video/photo/image and personal
identifiable information to be published on our social media handles such as newsletter, bulletin,
facebook and Instagram pages website or other social media outlets and publications.

As you are aware, there are potential dangers associated with the posting of personal identifiable
information on a web site 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
___________________________ (the organization) do want to celebrate your child and his/her work
and maintain a good line of communication.

As the organization, we will not release any personally identifiable information without prior written
consent from you as parent or guardian. Personal identifiable information includes student names,
video, photo or image, residential addresses, e-mail addresses, and phone numbers.

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 Chairperson of the organization and such rescission will take effect immediately
upon receipt.

Check one of the following choices:


o I/We GRANT permission for a video/photo/image that includes this child without any other
personal identifiers to be published on the organization’s website, newsletter, bulletin,
Facebook page, or other social media outlets and publications.

o I/We GRANT permission for this child’s video/photo/image and name to be published on the
organization’s website, newsletter, bulletin, Facebook page, or other social media outlets and
publications.

o I/We GRANT permission for this child’s video/photo/image and all other personal identifiers
listed above to be published on the organization’s website, newsletter, bulletin, Facebook page,
or other social media outlets and publications.

o I/We DO NOT GRANT permission for video/photos/images that include this student to be
published on the organization’s website, newsletter, bulletin, Facebook page, or other social
media outlets and publications.

Child name: ________________________________________________________________

Name of Parent/Guardian: ____________________________________________________

Signature of Parent/Guardian: _________________________________________________

Relationship to Child: ________________________________________________________

Date: ________________________________

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