Parent’s Permission | Public Library of Catasauqua

Name: Address: Email: Home Number: Cell Number: Texting :YesNo

School & Grade: Graduation Year from HS: Birthday (mm/dd/yy): Today's Date (mm/dd/yy): How did you hear about us? T-Shirt Size:

Permission to photograph/videotape (Required)

I understand that the Public Library of Catasauqua may photograph or videotape the events or activities in which my child is participating

I give my permission for the Library to use photographs or videotape of my child for the purpose of promoting the Public Library of Catasauqua and its services/programs.

Parent(s), please check your choice in the space provided.

Sign then print your name with the date. Thank you.

Yes, I give permission for the Library to use photos/video of my child/ren for the purposes stated above.
Child Name :
No – I do not give my permission to use photos or videos of my child.

Parent’s name (by entering your name, you are providing an electronic signature)

Date :

Permission to photograph/videotape (Required)

If you experience any issues accessing the above online resources, please contact the library for further instruction.