PHOTO AND VIDEO RELEASE - IT CAN WAIT ESSAY CONTEST
In consideration for any prizes, receipt and sufficiency of which is acknowledged, I give my
consent to the Pennsylvania NewsMedia Association, the Pennsylvania NewsMedia Association
Foundation and any Newspaper or other media entity participating in or publicizing the It Can
Wait campaign to use, reuse, publish, and distribute my/my child's name, photograph, likeness
and part or all of his essay in any media form and type of publication, including any print or
electronic/internet publication, without additional compensation and without restriction.
I further consent to my child being interviewed and videotaped in relation to the It Can Wait
campaign and give my consent to the Pennsylvania NewsMedia Association, the Pennsylvania
NewsMedia Association Foundation and any Newspaper or other media entity participating in or
publicizing the It Can Wait campaign to use, reuse, copyright, publish, and distribute any such
video or the contents of any such interview in any media form and type of publication, including
any print or electronic/internet publication, without compensation and without restriction.
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Student’s Name
_____________________________________ ____________________________________
Parent’s Name Parent’s Signature and Date
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signature
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