Photograph Videotape Release Form

Photograph / Videotape Release Form

I give unconditional permission to Learning Independence Through

Computers, Inc. (V-LINC) to photograph/Videotape me or my child(ren) and

to use the photographs or videotape for: general education about V-LINC

and children and adults with disabilities and for fundraising purposes. The

photograph/video may be used on our website, in publications and/or

presentations for V-LINC.

Printed Name:________________________________________________

Signature: _________________________________

(Guardian if under 18)

Date: ________________

For Office Use: List filenames of pictures:

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Parent category: Legal