Maine Department of Education Consent form



Maine Department of Education Consent formI grant the Maine Department of Education permission to distribute my likeness and voice on a video, audio, photographic, digital, electronic or any other medium (collectively referred to as ‘the recordings’). The Department may use my name in connection with these recordings and may also use, reproduce, exhibit or distribute in any medium (e.g. print publications, video tapes, CD-ROM, Internet/WWW/social media) these recordings for any purpose that the Department, and those acting pursuant to its authority, deem appropriate. I also allow the Department to publish the text and/or transcript of my spoken words. Publication may include print publications, video tapes, CD-ROM, and/or Internet/WWW/social media) distribution.Signature: ________________________________________________________________________________Printed name: ____________________________________________________________________________Title, School/District/Company: ________________________________________________________E-mail address: ____________________________________________________________________________Parent's or guardian's signature (if under 18): _________________________________________Date: ________________________________Updated January 2019 ................
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