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*Serious offenses such as cyber bullying and or illegal use of technology, will result in a meeting with
the principle and possible loss of technology privilege for an extended period of time. Students and
Parents/ Guardians should read the student handbook as there could be additional consequences
regarding illegal behavior, including harassment.
Signatures Date
Student’s Name
Parent’s Name
Parent’s Signature
This permission slip form is intended to allow me to take pictures and/ or videos of the
students in the class for class projects, class scrap books, and/ or gifts to parents from the kids.
The pictures I take of the students in this class will only be used for classroom projects and to
share with the families what the students have been learning about and working on in our
classroom throughout the year.
Please sign the information below and return the completed sheet to me, Ms. Barrett,
before school starts. If you have any questions or concerns, please email me at
mtb0401@westminstercollege.edu and I would be happy to answer them.
Thank you!
Signatures Date
Student’s Name
Parent’s Name
Parent’s Signature