Release Form
I, ________________________________, hereby agree and consent to allow the Arkansas Department of
Education (ADE), and anyone authorized by ADE, to use the name, school district, and hometown and to
reproduce, edit, alter, or publish photographs, audio, and video recordings of my child, children, or myself
and their/my work products (“my/child’s information”) without payment or any other consideration.
I understand that the ADE owns a copyright and all other media distribution rights for any publication in
which my/child’s information appears and may exclusively use this in any manner, in whole or in part,
including print, broadcast, digital media, or online. I understand that publications containing my/child’s
information will become property of ADE and will not be returned.
Furthermore, I, on behalf of myself, my child or children, and any person acting on our behalf, herby
consent and agree to release any and all claims or causes of action against ADE and any of its
associates, employees, or agents associated with the release of my/child’s information that is in the
possession or control of ADE and is used or released as part of the normal course of business of the
ADE.
Parent’s Name or Adult (Please print.) Child’s Name or
Children’s Names (Please print.)
Signature of Parent or Adult (Please sign in cursive.)
Date
