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Photo Release 20-21

Please complete the form below. Required fields marked with an asterisk *

Photo Release 20-21

Contact Information

Student First Name*

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Student Last Name*

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School*

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Student JCPSNJ email*

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Parent email*

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Parent Phone*

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Parent Work Phone

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Please check each that applies. *

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I hereby give my permission for the Jersey City Public Schools to release photographs, videotapes, and/or the name of my child to the media for the 2020-2021 school year.

I give my permission to post my child's photograph, videotape, or name on the District's Facebook page.

No, I do not want my child to be photographed or videotaped.

Only parent and guardians can complete this form. *

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I certify that the information provided above is accurate and completed by the student's parent or guardian.

Please type your full name. (electronic signature)*

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Confirmation Email

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