Media Release Form

Parent Name

Student Name(s). Please list all students you have currently enrolled with Class Source.

Select only one:

I consent for my student(s) to appear in media (interviews, photos and/or videos) used for Class Source's website, social media, newsletter, news releases, or other promotional materials. The images will be the sole property of Class Source of Tampa, Inc. I hereby release and hold harmless Class Source of Tampa from any claim arising from the use of these images.

I do NOT grant permission for my student(s) to appear in media (interviews, photos and/or videos) taken on campus. I understand this means my child may be edited out or blurred over for any group videos/photos taken in class or on campus, and/or that my child may be excluded from interview, video, and photo opportunities on campus when they arise.

Re-type parent name as electronic signature

Thank you!