3 Different Ways to Access the Model Release Form

For Use of Student’s Name, Picture, or Materials For Publication, Broadcast, Pen-Pal Exchange, Web Site Posting, and Class Projects.

Dear Parent/Guardian:

Your child's picture, name, or work may be used in one of the following ways:

  • Posted to the school system or school website on the Internet.

  • Submitted to publishers for publication.

  • Shared with other students in pen-pal projects.

  • Broadcast on television, radio, newspapers, and district social media.

  • Used in a demonstration project to be presented at conferences or workshops.

  • Published in the school yearbook.

I understand that directory information will be provided. I agree that Nash County Public Schools and those whose use of the publication, broadcast, pen-pal exchange, or website is authorized by the schools shall not be held liable for such use, display, on website, conference, or publication. I also understand that the Family Education Rights and Privacy Act, 20 U.S.C.s 1232 g, prohibits the disclosure of any confidential education record regarding my child without my written consent.

Permission is hereby granted for news photographers or videographers to photograph or record my child during the school day and at school-related activities for the expressed purpose of publication and broadcast. Permission is also granted for my child's work or picture to be published on the Internet and shown at conferences. Student work will appear with the student's first name and last name; no home address or telephone number will appear with the work.

By mandate of N.C. Law Senate Bill 49 / SL 2023-106.

How to Sign the Model Release Form: Guardians can sign the form through three different access points. This approach aims to accommodate all guardians and ensure equitable opportunities for all our families.

Option 1:

Sign the form via the App using ROOMS!

Beginning January 1, 2024 - for your child to have their picture/video/audio-recording taken, the student's parent/guardian has to Opt-In their child.

The model release form also permits your child to be in the yearbook or included in any school-related social media. While opting in is not mandatory, students who aren't opted in will not appear in any new media content produced by the school or district. You can locate this form inside the Materials Section -> "Mandatory" folder -> "updated model release form."

Option 2:

Sign this form via the following link listed below: (This is only applicable for DS JOHNSON Elementary students.)

Option 3:

If you do not have access to the Internet or have a difficult time with technology, please contact your school to receive a hard copy of the document.