Permission Slip for Using Pictures and Name on National Academic Games Web Site

I, ,

(Name of Participant)

hereby give Betty Smith, webmaster for National Academic Games (http://academic-games.org)

(Creator of Web Page)

permission to use my picture and my name on the National Academic Games web page as part of a group picture or as a candid shot. I understand that my last name will not be used in conjunction with my picture in such a fashion as to identify me.

Signature of Student Date

Signature of Parent or Guardian Date

Permission Slip for Using Pictures and Name on National Academic Games Web Site

I, ,

(Name of Participant)

hereby give Betty Smith, webmaster for National Academic Games (http://academic-games.org)

(Creator of Web Page)

permission to use my picture and my name on the National Academic Games web page as part of a group picture or as a candid shot. I understand that my last name will not be used in conjunction with my picture in such a fashion as to identify me.

Signature of Student Date

Signature of Parent or Guardian Date