Please submit the form and artwork by February 3, 2023. Please print and attach signed form to the back of artwork with a small piece of masking tape. |
Questions: tcoffman@everettsd.org |
Artist Release Form |
First Name | Last Name | Student No. |
Address | City | Zip Code |
Parent/Guardian Name | Parent/Guardian Phone Number |
Yes
| No
|
I authorize Everett Public Schools to display my artwork labeled with my name in a public space at the Community Resource Center. |
Yes
| No
|
I authorize Everett Public Schools to use my name when accompanied with images of my artwork on the district website or in other district publications. |
Yes
| No
|
I authorize Everett Public Schools to use images of my artwork on the district website or in other district publications. |
Artist Signature | Date |
Parent/Guardian Signature (Required only if not permitted via the Rights and Responsibilities Form (FERPA) on file) |
Student Name | Artwork Title |
Grade | Elementary School |
Teacher |