Photo/Video Release Form
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 Elementary/ Middle School/ High School Technology Fair
Photo/ Video Release Form


To Whom It May Concern:

I hereby consent to have my child                                                    photographed, videotaped, or interviewed while at the Horry County Technology Fair. I consent to the use of my child’s photograph or likeness in school newsletters, local newspapers, the HCS Web site, or other electronic/digital/print media. I understand that my child may be identified by name, grade or school.

Child’s Name:___________________________________________________            

School: __________________________________________ Grade:_____________

Teacher/Sponsor:______________________________________________________

Parent/Guardian Name:________________________________________________
Phone Number(H) :  _________________________  Cell:______________________
Parental e-mail:  ________________                                   ___________________


Signature of Parent or Guardian:________________________________________

Date: ________________________ ___

Horry County Schools

335 Four Mile Rd. | PO Box 260005 | Conway, SC 29528

Phone 843-488-6700

Horry County Schools does not discriminate on the basis of race, religion, color, national origin, sex, disability, age, immigrant status, English-speaking status, or any other characteristic protected by applicable federal or S.C. law in its programs or activities. For questions regarding the nondiscrimination policies call 843-488-6700, or write Horry County Schools, 335 Four Mile Rd., Conway, SC 29526 or click here for a list of contacts.

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