STUDENT RELEASE FORM
Introduction
Ohio teachers begin their careers with four-year resident educator licenses, and they must complete all four years of the
Resident Educator Program and successfully pass the Resident Educator Summative Assessment (RESA) in order to
advance to a five-year professional educator license. The assessment calls for Resident Educators (REs) to demonstrate
their ability to design and implement instruction that engages students in complex thinking and in using formative
assessment to inform their teaching practices.
As part of this assessment, your child’s teacher will be recording him or herself at work with your child’s class, as well
as recording the children at work with each other and individually.
Privacy
The recordings are intended for educational and professional development use. They will be viewed by members of
Ohio’s Resident Educator Program, other educator training and professional development programs and their various
partners and collaborators, using the Internet and other media. The recordings will not be disclosed to or viewed by
anyone else unless such disclosure is permissible under the Family Educational Privacy Rights Act (FERPA) and other
applicable laws.
Agreement
I give my permission to ________________________________ (name of school/district), and those authorized by it, to
videotape, photograph, and record in any medium my child's appearance, voice, and school work in the classroom, online,
and on school grounds for use by or in connection with the Ohio Resident Educator Program, the Ohio Resident Educator
Summative Assessment (RESA), other training and professional development programs or offerings for educators, and
their partners and collaborators.
I grant to ________________________________ (name of school/district), and those authorized by it, the rights to use
and display my child’s likeness in recordings for purposes associated with the Ohio Resident Educator Program, the
Ohio Resident Educator Summative Assessment (RESA), and other training and professional development programs or
offerings for educators, and their partners and collaborators. The video may also be used by test developers under secured
conditions for program development and implementation, including scorer training, and to support continued program
improvement activities such as future validity and reliability studies.
I understand that ________________________________ (name of school/district) or others authorized by this release
will edit the footage to illustrate specific teaching and/or content issues, and I release and will hold
harmless________________________________ (name of school/district), its officers, employees, and agents and others
authorized by this release from all claims, demands, and liability of any kind stemming from the distribution of these
teacher professional development and related programs. I agree that I have no ownership interest in the recordings
discussed above, or in any of the programs produced from these recordings.
I do not grant permission for my child to be recorded, filmed, photographed. Please initial here: _____
I do grant permission for my child to be recorded, filmed, or photographed. Please initial here: _____
_________________________ _________________________
Student’s Name Teacher/School
_________________________ _________________________ _________________________
Parent/Guardian’s Name Parent/Guardian’s Signature Date
