Students who attend school in the Mabank Independent School District are occasionally asked to be a part of school and/or District publicity, publications and/or public relations activities. In order to guarantee student privacy and ensure your agreement for your student to participate, the District asks that you and the student sign and return this form to the school for each of your children.

The form referenced below indicates approval for the student's name, picture, art, written work, voice, verbal statements or portraits (video or still) to appear in school publicity or District publications, videos or on the District's website. For example, pictures and articles about school activities may appear in local newspapers or district publications. These pictures and articles may or may not personally identify the student. The pictures and/or videos may be used by the district in subsequent years.

AGREEMENT
Student and Parent/Guardian release to Mabank ISD the student's
name, picture, art, written work, voice, verbal statements,
portraits (video or still) and consent to their use by MISD.

Mabank ISD agrees that the student's name, picture, art, written work, voice, verbal statements, portraits (video or still) shall only be used for public relations, public information, school or district promotion, publicity, and instruction.

Student and Parent/Guardian understand and agree that:

• No monetary consideration shall be paid;
• Consent and release have been given without coercion or duress;
• This agreement is binding upon heirs and/or future legal representatives;
• The photo, video or student statements may be used in subsequent years.

If the Student and Parent/Guardian wish to rescind this agreement they may do so at any time with written notice.

Effective Date of Agreement:________________________________
 

Student's Name:________________________________
(Print Name)
________________________________
(Student's Signature)

Parent/Guardian:________________________________
(Print Name)
________________________________
(Parent/Guardian Signature)

Pursuant to Texas Education Code, Section 26.009(b)(2)