Editing previous response:

Please fix the highlighted areas below before submitting.

Photo Waiver

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

Pomeroy School District uses Facebook to communicate with families and community memebers about events going on within our schools. In addition, we often share pictures of our celebrations and activities. These pictures often include our students.

Please indicate below what your preference is regarding your child(ren).

I agree for my child(ren), listed below, to have his or her picture taken and included on the Pomeroy School District's website: https://www.psd.wednet.edu and/or Pomeroy Elementary/High School Facebook page.*

Answer Required

Yes

Student's First and Last Name:*

Answer Required

Student's First and Last Name:

Answer Required

Student's First and Last Name:

Answer Required

Student's First and Last Name:

Answer Required

This consent shall not allow any further publication or broadcast of such picture by any other party, or in any other location or format without my advance written authorization.

Please provide your Full Legal Name below:*

Answer Required

Today's Date*

Answer Required

Confirmation Email

Email Required