Please review media consent and complete required fields by September 15th. If you have any questions or concerns, please reach out the the administration office by calling (773) 891-5130 or emailing [email protected].

Student Media Consent and Release Form

Throughout the school year, students may be highlighted in efforts to promote CCA activities and achievements.  For example, students may be features in materials to train teachers and/or increase public awareness of our schools through newspaper, radio, TV, the web, displays, brochures, and other types of media. 

I, as the parent/guardian of the student listed above, hereby give CCA and its employees, representatives, and authorized media organizations permission to print, photography, and record my child for use in audio, video, file, and other electronic, digital and printed media.

1. This is with the understanding that neither CCA nor its representatives will reproduce said photography, interview, or likeness for any commercial value or receive monetary gain for use of any reproduction/broadcast of said photograph or likeness. I am also fully aware that I will not receive monetary compensation for my child’s participation. 

2. I further release and relieve CCA, its Board of Trustees, employees, and other representatives from any liabilities, known or unknown, arising out of the use of this material.
   

I certify that I have read the Media Consent and Release Liability statement and fully understand its terms and conditions. 

Please understand that failure to consent or not consent this release form within (15) school days from the start of school will constitute approval of the above request.