Multimedia Permission

Release Form

We, the Flandreau Indian School, request permission to print your son / daughter's picture (or group pictures) for our Internet web site, newspaper, Parent Newsletter, Gifted & Talented events, Outreach, the city's television Public Service Announcements, etc.

Please fill out the following information and send back to FIS with your application:

Student's Name: (Please print) ______________________________________________________

Parent's Name: (Please print) _______________________________________________________

Check one:    Yes, I agree to have my child's picture printed on FIS' web site, newspapers, newsletters, and other events.

                     No, I do not agree to have my child's picture printed.

Parent's Signature: _______________________________________________________________

Date: ___________________________

Please send this form to:

FIS Webmaster

c/o Flandreau Indian School

1132 N. Crescent St.

Flandreau, SD  57028

or fax to: FIS Webmaster

(605) 997-5202