Parent's Name *

First Name

Last Name

Parent's Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student #1 Name *

First Name

Last Name

Student #2 Name

First Name

Last Name

Student #3 Name

First Name

Last Name

Student #4 Name

First Name

Last Name

Consent Form

The Shane Lalani Center for the Arts takes photographs and video during some rehearsals and performances. We use these photos and videos for our website, publicity materials, grant applications, reports to granters and sponsors, and for archive. The Shane Lalani Center for the Arts has my permission to use, edit, and reuse photographs and videos of the student(s) named above to promote the Shane Center and its programs.

I Consent