Photograph Release Form

If you would like to submit photographs for publication in this newsletter picturing your classroom performing magic, please submit a photograph which we will scan for the newsletter, along with the text you propose to accompany the photograph. Include on the back of each photograph the name of each student in the photograph. The name and location of the school will be published, HOWEVER, no names of students will be used in the articles. We do request, however, that you submit the students' names with the photographs, as well as a release from the parents allowing the publication of their child's photograph.

PARENTAL CONSENT FORM FOR PUBLICATION OF PHOTOGRAPHS IN INTERNET NEWSLETTER

Please let this form serve as my authorization to have my child's photograph published in the website Newsletter of the Magic for Special Ed Program sponsored by the Society of American Magicians which will also be linked to the Society of American Magicians' home page of its website.

School Submitting Photograph:

_________________________________________________________________________

Child's Name (printed):

_________________________________________________________________________

The following may be signed by either the mother/father/or legal guardian.

_________________________________________________________________________

Mother's Name (printed):

_________________________________________________________________________

Mother's Signature:

_________________________________________________________________________

Father's Name (printed):

_________________________________________________________________________

Father's Signature:

_________________________________________________________________________

Legal Guardian's Name (printed):

_________________________________________________________________________

Legal Guardian's Signature:                                                                   Date:

_________________________________________________________________________

All donations to the Society of American Magicians Magic for Special Education Program should be made payable to:

Society of American Magicians
Magic Endowment Fund, Inc.,

a Non-Profit Foundation for the advancement of the Art of Magic, and mailed to:

Harry Monti
803 Sherwick Terrace
Manchester, Missouri  63021

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