NOTE: All those who sign up by move up day this

year will receive priority spots for Fall Rally!

(08 – 09)

- COMPLETED PHOTO RELEASE FORM

four
placed in MRS. COSTA’S mailbox in the main office or drop them off in
Room 514. Key Club’s executive board will not be held liable for them.
 MONTVILLE TOWNSHIP HIGH SCHOOL

CODE OF CONDUCT

We have read and understand the Code of Conduct of Montville High School and
agree to comply.

We also understand that participation in extracurricular activities is a privilege and

that we are representing Montville Township High School. Montville Township High
School recognizes that actions, both positive and negative, reflect directly on our
school and organization. We understand that consequences may follow as a result of
violations of this Code of Conduct.

I _____________________________ wish to participate in the following

Student Name
activity ________Key
Key Club________
Club for the 2008-2009 school year.

I UNDERSTAND THAT I MUST PERFORM 50 HOURS OF

COMMUNITY SERVICE FOR THE YEAR.

_____________________________
Print Student’s Name

Date: ___________ Signature

Signature:__________________________
nature:__________________________
Student

Date: ___________ Signature:__________________________

Signature:__________________________
Parent/Guardian

Please sign and return this page only and not the actual code pages.
 Montville Township Public Schools
Parental/Guardian Consent Form
Photos and Videos for Public Release Including the Internet

I am sending you this letter to inform you and to request your permission for your child’s
photo/image and/or videotaping of personally identifiable information to be published on
the Montville Township School District Internet site.

As you are aware, there are potential dangers associated with capturing
personally identifiable information since global access to the Internet or viewing
of a videotape or cable program does not allow us to control who may access
such information. These dangers have always existed; however, we as a school
system do want to celebrate your child and his/her work. The law requires that we
ask for your permission to use information about your child.

Pursuant to law, we will not release any personally identifiable information without prior
written consent from you as parent or guardian. Personally identifiable information
may include one or more of the following: student name, photo or image, school
address, e-mail address, and locations and times of Montville trips and classes
and events.

If you, as the parent or guardian, wish to rescind this agreement, you may do so at any
time in writing by sending a letter to the classroom teacher and such rescission will take
effect upon receipt of the letter.

Check ONE of the following choices:

1. I/We GRANT permission for this student’s photo/image/videotaping, name and
school listed below to be published on the Montville Township School District Internet
site and/or other media, e.g. press release.

2. I/We DO NOT GRANT permission for photo/image/videotaping that includes this

student to be published on the Montville Township School Internet site and/or other
media.

Photo(s)/image(s) posted on the Internet will appear on the Montville Township website
at www.montvillekeyclub.com
______________________________________________________________________

Student’s Name: (please print) ___________________________Student’s Grade: ___________

Student’sSchool________________________________________________________________
Print name of Parent/Guardian: (Print) ______________________________________________
Signature of Parent/Guardian _____________________________________________________
Relation to Student: _________________________ Date: ____________________________

Send permission form to:

Ernestine Costa
Montville Township High School
100 Horseneck Road
Montville, NJ 07045
email:ecosta@montville.net