Personal Appearance Release
For good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, I hereby grant the Buffalo City School District the following rights
relating to the School District’s possible use of my child’s appearance in a still or
video production to be produced by the School District by

__________________________________________________________________

Date _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

at    _____________________________ in the City of Buffalo.



   1. The School District may use my child’s likeness and voice for the purposes of
    advertising, publicity and sales promotion, but not as a direct endorsement of
    any particular product or service.

   2. I acknowledge that I have not been promised, and do not expect to receive any
    fee, payment, reimbursement or other remuneration in connection with the
    Programming, but that I have agreed to allow my child to appear for purely
    personal considerations.



AGREED TO AND ACCEPTED THIS ___________ DAY OF __________________


_____________________________                  ______________________________
signature                            address

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_______________________________________________
please print your name

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child’s name (please print)