Student Photo & Video Release - Online

Below is the Online version of the Student Photo & Video Release form. Please fill out all the required fields before submitting.

Please enable JavaScript in your browser to complete this form.
Student's Name
Parent/Guardian Agreement
During the school year, your child's picture or video may be included on the school's webpage, graduation slideshows, award presentations, teacher and staff Facebook pages, and Instagram accounts. While your child's name may accompany the photo or video, no other confidential information will be included with your child's picture or video when published on the Web.

In granting this permission, I understand that the Richlands Christian Academy may use photos/images/videos of my child for purposes such as celebrating achievements and publicizing education events, as deemed appropriate by staff of the school, and that such use may include display on social media sites.

I am signing this release form below with the knowledge that any photos/images/videos posted on these sites can be downloaded and reprinted by others, and I, therefore, release the Richlands Christian Academy from any liability arising from use of my child's photos/images/videos in their postings. Additionally, I understand that there are potential dangers associated with the posting of personally identifiable information on websites, since global access to the Internet does not allow for control of who may access such information.

Please sign the release form below and return to the school. Your permission grants us approval to publicize without prior notification and remains in effect until revoked.
Please read the Description and Choose One Option
I/We Do or Do Not give permission for this student's picture or video to be used as described above. We are or are not willing to release this into the public domain and understand the benefits and risks of doing so. Please choose one of the options above.
Parent/Guardian Rescind Agreement
I understand that if I wish to rescind this agreement, I may do so at any time by sending a written request to the school. The requested rescission will take effect upon receipt of notification.
Parent/Guardian's Name
Parent/Guardian Electronic Signature & Date