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Center for STEM Learning Dole Human Development Center | 1000 Sunnyside Ave., Room 3078 | Lawrence, KS 66045-‐7511 | (785) 864-‐2379 | Fax (785) 864-‐1336
PHOTOGRAPHY CONSENT FORM / RELEASE FOR MINOR CHILDREN (Under 18)
I, (print name)_________________________________________, parent or
official guardian of (child’s name)________________________________hereby grant permission
to the University of Kansas Center for STEM Learning, to take and use: photographs and/or
digital images of my child for use in news releases and/or educational materials as follows:
printed publications or materials, electronic publications, or websites. I authorize the use of
these images without compensation to me. All negatives, prints, digital reproductions and
shall be the property of the University of Kansas Center for STEM Learning.
___________________________________________ (Date)
___________________________________________ (Signature of Parent or Guardian)
___________________________________________ (Address)
___________________________________________ (City, State, Zip)