Publicity and Photo Release Form
We are very proud of the positive activities, honors and achievements of the students
participating in the BJHS/Illinois Wesleyan University Promise and Potential program. As
a result, we are making every effort to promote these accomplishments through school
and District-wide publications and websites, local newspapers, radio and television
During the school year, your student may be in a situation where they may have the
opportunity to be interviewed and/or photographed by IWU students or staff, by their
teachers, by other District 87 staff, or by members of the local media.
We understand that some parents may have objections to their student being interviewed
and/or photographed. Please let us know your wishes regarding photos and publicity by
completing and returning the following form:
Student Name_____________________________________ Team______________
___ I give permission for IWU coaches and BJ staff to photograph my student.
___ I give permission for IWU and BJ personnel to use these photos for educational purposes only.
___ I give permission for my child to be interviewed and/or photographed/filmed for use in
publicity, reporting, and research related to this BJHS/IWU project.
___ I also give permission for my child’s name to be printed/used.
___ I request that you do not interview or photograph my child.
Please return this form to your student’s Roundtable teacher as soon as possible.