Students over the age of 18 may sign for themselves; students under 18 must have this release signed by their parent or guardian.
I hereby consent to the use of this photograph or video of my child/dependent/self, and/or any copies of this photograph or video in any editorial and/or promotional material produced and/or published by the National Science Teaching Association.
I understand that signing this release does not guarantee publication of the photo.
Name of student in the photo or video
_____________________________________________
Name (Adult or Parent/Guardian)
_____________________________________________
Signature (Adult or Parent/Guardian)
_____________________________________________
Date: _______________
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