Rocky Mount Middle School

NCPS employs various media for educational & promotional purposes: photos, videos, audio recordings, & written narratives of students. These may be featured on school & district websites, social media, printed/digital materials, & shared with external organizations or the media & serve as the permission until the student changes schools. This form allows guardians to grant permission for their child's image to be used. If you don't opt-in it will be assumed an Opt-Out.

1) Select Your Child's School Required*

Please select your child's school. If their school is not listed - you are in the wrong form.

Not Listed

2) Student ID Number Required*

3) Your Child's Name Required*

4) Your Child's Grade Required*

5) Option 1 - OPT-IN - YES Required*

I hereby grant Nash County Public Schools permission to capture use photographs, videos, audio, and written narratives of my child during instructional school activities throughout the current school year for display, publication, or release to external organizations in print, video, and/or digital media.

OPT IN YES

Opt-in yes

6) Best Contact # Required*

7) Parent/Guardian Name Required*

8) Parent / Guardian Email Required*

9) Parent/Guardian Signature Required*

By signing below, you acknowledge that you have read and understood the terms of this consent form. This consent covers various media types, including but not limited to photographs, videos, audio recordings, and written narratives. It pertains to school-related activities during the current school year.

Signature

I understand that my typed signature is the legal equivalent of my handwritten signature on this document.

Rocky Mount Middle School
Forms

Forms

Rocky Mount Middle 2024 Updated Model Release Form

1 forms were found.

Find Us

Rocky Mount Middle School841 Nash StreetRocky Mount, NC 27804Phone: (252) 462-2010Fax: (252) 985-4321

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