Media Release Parent Full Name: Parent Email Address: My signature serves as authorization for The Carolina Academy to: ● collect samples of my child’s work ● take photographs of ● make audio and/or visual recordings of my child and/or me throughout our involvement with school, athletics, clubs, etc., with The Carolina Academy. I understand that The Carolina Academy may present, publish and/or edit for publication any of the above materials to be used for educational or informational activities. No commercial use of my image, voice or work will be allowed without further permission from me. Student Name: Grade: —Please choose an option—2K3K4K5K1st2nd3rd4th5th6th7th8th9th10th11th12th Parent Signature: Agreement Date: Δ