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Media Release Authorization

Choose Yes or No for each media use, sign, and PNCC will receive your completed authorization.

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Family Information

Media Use

Consent is voluntary and will not affect your child's enrollment or care.

Photograph my child

Video record my child

Audio record my child

Use media in PNCC newsletters, displays, portfolios, or materials shared with enrolled families

Post media on PNCC public social-media accounts

Use media on PNCC's website or other official online presence

Use media in PNCC advertisements, flyers, brochures, or promotional materials

Use media for community events, presentations, public promotion, or appropriate entertainment content related to PNCC

Child Identification

Signature

I have read and understand this authorization and voluntarily indicate my choices above.