Consent to Post Student Artwork on Website

I hereby give the Massachusetts Department of Elementary and Secondary Education permission to post artwork created by my child _____________________________(child's name) on its website, and to include with the piece my child's first name, age, and the name of the child's school district. I also give the Department permission to reproduce my child's artwork for non-commercial purposes such as, but not limited to, brochures or employee-recognition certificates. I understand that the Department will not publish or otherwise release my child's last name or address.

I represent that I am the parent or legal guardian of
____________________________(child's name).

My child's first name is:_____________________________
My child's age is:_____________________________
My child's school district is::_____________________________

Signed_____________________________(parent or legal guardian)

Date_____________________________

I hereby give the Massachusetts Department of Elementary and Secondary Education permission to post my artwork on its website and to reproduce my artwork, as outlined above.

Signed_____________________________(student artist)

Date_____________________________