Embed Size (px)
Citation preview
Media Permission SlipContact: Lindsey Tomsu, Teen Coordinator (402) 537-3900 [email protected]
La Vista Public Library
MEDIA PERMISSION SLIPDate:
I, ________________________________________________, give permission to the
La Vista Public Library
to make or use pictures, slides, digital images, or other reproductions of my teen,
______________________________________________________, or of materials
owned by my teen, and to put the finished pictures, slides, or images to use without
compensation in productions, publications, on the web, or other printed or electronic
materials related to the role and function of the La Vista Public Library Teen Advisory
Board (TAB) Newsletter.
Address Street, City, State, ZIP
Signature
Telephone Area/No.
