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Student s Name please print Student s Grade circle one Kinder 1st 2nd 3rd 4th 5th 6th 7th 8th 9th Parent /Guardian Name please print Relationship to Student Date Updated 5/23/17. The photos and/or videotapes will be used in STEM Academy publications displays television programs or news releases. Part One This is to certify that I give my permission for my son/daughter to be photographed or videotaped by any UTPB STEM Academy employee. I herby agree to the use of my child s photo video and/or...
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