Top Scholar Information, Part 2 (Parents)

Informed Consent

Please print, sign, scan (or take a picture of) and email to by the March 10, 2018

We are extremely proud of the accomplishments of our Top Scholars and we would like to honor them at the Grove Educational Foundation For Excellence Gala on April 7, 2018.

In addition to introducing the Top Scholars to our guests, we would like to share their name, picture and educational information on social media, our website, with the media outlets and we would like to include the information in a Power Point presentation used at the GEFFE banquet, distributed to other scholars and posted on social media. The Top Scholars have worked very hard for this honor, and we want them to be an inspiration for the coming classes of students.

If a suitable professional picture is not submitted by the student by the due date of March 10, we will use the yearbook picture.

Students Over The Age of 18

I, ______, hereby give the Grove Educational Foundation for Excellence the right and permission to use and publish information regarding my Top Scholar status, including my photograph, educational information and personal information as stated above on various social media sites, media outlets, websites and on a Power Point at the Gala.

I hereby release, discharge and agree to save harmless the Grove Educational Foundation for Excellence from any liability resulting from usage of the above-mentioned information and/or photographic images or use of my name.

______

(Signature)(Date)

Parental Consent for Students Under The Age of 18

I, ______, hereby give the Grove Educational Foundation for Excellence the right and permission to use and publish information regarding my child named ______and his/her Top Scholar status, including his/her photograph, educational information and personal information as stated above on various social media sites, media outlets, websites and on a Power Point at the Gala.

I hereby release, discharge and agree to save harmless the Grove Educational Foundation for Excellence from any liability resulting from usage of the above-mentioned information and/or photographic images or use of my child’s name.

______

(Parent Signature)(Date)

Top Scholar Name: ______

Phone Number: ______

Address: ______