MEDIA OPT-OUT FORM
 

Dear Parent/Guardian,

Your student has registered as a participant in the World Affairs Challenge (WAC) and as such will be subject the WAC Release and Permission Policy granting permission to the Center for Teaching International Relations (CTIR) and its WAC program to photograph and to record your child’s voice, performances, poses, acts, and appearances, and to use his/her biography and picture, photograph, silhouette and other reproductions of his/her likeness and sound during his/her participation in the WAC. You have also agreed to the unlimited distribution, advertising, promotion and exhibition of the Works for promotion of CTIR using any method or device now known (including video, print, multimedia, social media, website or film, etc.) or hereafter devised.

If you do not want to grant these permissions, please complete the form below. By submitting this form, the World Affairs Challenge (WAC) will make every attempt to not allow the release of your child’s image (i.e. photograph, videotape) or the content of interviews, to the extent such activities and the release of such data is within the WAC’s control.

Thank you for your cooperation.
 

Student’s Name *
Student’s Name
Parent/Guardian's Name *
Parent/Guardian's Name
If student is under 18 years of age
Parent/Guardian's Phone Number *
Parent/Guardian's Phone Number
Form Submission Date *
Form Submission Date