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Beit Rayim Hebrew School PHOTOGRAPH PERMISSION FORM FOR 2011/2012

Photograph and Videotape Permission Beit Rayim Synagogue and School may take photographs or videotapes for use in promotional materials. We do not post names with the pictures. Please indicate if you agree to this for you and/or your child(ren) by checking the box below.

I give permission for photographs or videotape of me and/or my child(ren) to be used by Beit Rayim Synagogue and School for promotional purposes.

Family Name (please print): _____________________________________________ Student’s Name: ___________________________________________ Grade: ____ Student’s Name: ___________________________________________ Grade: ____ Student’s Name: ___________________________________________ Grade: ____ Student’s Name: ___________________________________________ Grade: ____ Signature of Parent/Guardian: _______________________ Date: _____________

School and Synagogue office: 209- 1118 Centre Street, Thornhill, ON L4J 7R9 School tel. #: 905-889-0276 x. 32 E-Mail: school@beitrayim.org

www.beitrayim.org - facebook.com/beitrayimhebrewschool


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