SDES MEDIA PERMISSION FORM

Your Permission

Specially Designed Education Services (SDES) requests your permission to use templates/activities/worksheets and/or testimony/videos/photos/audio recordings of you or your child as part of our ongoing efforts to highlight exceptional teachers and individual student successes and show the effectiveness of the programs we publish (The Styer-Fitzgerald Program for Functional Academics, Beyond Expectations, Life after School, Effective Strategies for Working with Paraeducators, etc.). The purpose of these efforts is to improve the skills and knowledge of educators, administrators, service providers, and families. Examples of products and services in which testimony/videos/photos/audio recordings of you or your child may be used include websites, social media, presentations, trainings, educational consultations, and publications (electronic and print).

​By submitting any media, I understand and acknowledge that:

• My permission is voluntary;
• I am the person named on this submission, or I am the parent/guardian of the person named on this submission;
• Media may be provided by SDES to school districts and trainers to be used for the sole purpose of educating others; 
• No payment shall be made to me or my child for the use of the templates/activities/worksheets or testimony/photos/videos/audio recordings;
• I release SDES from any and all liability and claims including libel and invasion of privacy, and from any and all personal property rights resulting from the use of the templates/activities/worksheets and/or testimony/photos/videos/audio recordings;
• This permission remains in effect until I notify SDES in writing that I wish to revoke it for future projects.

---

      By submitting the form below, you agree to the above provisions.