DeKalb County School System

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					       DeKalb County School System
 Student Publication and Production Release
                    Form
I (we) give permission for __________________________________(Student’s Name)

To be photographed, interviewed an/or televised for use in public relations
communications through newspapers, magazines, books, movies, videotape, Internet
or educational media.

Signature: ___________________________________________ (Parent/Guardian)

Address: ____________________________________________________________

Phone: ____________________________ Date: ___________________________

                          This document will be kept on file

				
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