Temporarily doubles up with friends Awaiting permanent foster care □ □ or relatives due to economic hardship Living in a shelter Homeless migrant family, children, □ □ and youth Living in a car None of the above □ □ Information and Photograph Release A cadet’s photograph/video clip, or any form of media may be released to be used in newspapers, school newsletters, or on broadcast stations to promote Willamette Leadership Academy. Please let us know if you agree to allow your child’s photo to appear as follows and sign the media release form: for media release Yes No □ □ on the Willamette Leadership Academy website Yes No □ □ on the Willamette Leadership Academy Facebook page Yes No □ □ in the Willamette Leadership Academy yearbook Yes No □ □ Do not use my student’s information or image in any form of publicity. □ Directory Information: Student directory information may be published. Directory information may include: student’s name, address, home phone number; student’s image; participation in officially recognized sports and activities; degrees or awards received. Please include my student’s information in the school directory. □ Do not include my student’s information in the school directory. □ Color Guard and/or Military Drill Team: In order for a student to be a member of Willamette Leadership Academy’s Color Guard and/or Military Drill Team students may not be on the Not “Do Photo” list, because these teams participate in public events which may be photographed by the media. My student may participate in the Color Guard and/or Military Drill Team, if eligible, and I understand that they may be photographed and the photographs may be publicized. Yes No □ □ *High School Students Only
□ Temporarily doubles up with friends or relatives due to economic hardship □ Awaiting permanent foster care □ Living in a shelter □ Homeless migrant family, children, and youth □ Living in a car □ None of the above Information and Photograph Release A cadet’s photograph/video clip, or any form of media may be released to be used in newspapers, school newsletters, or on broadcast stations to promote Willamette Leadership Academy. Please let us know if you agree to allow your child’s photo to appear as follows and sign the media release form: for media release Yes □ No □ on the Willamette Leadership Academy website Yes □ No □ on the Willamette Leadership Academy Facebook page Yes □ No □ in the Willamette Leadership Academy yearbook Yes □ No □ □ Do not use my student’s information or image in any form of publicity. Directory Information: Student directory information may be published. Directory information may include: student’s name, address, home phone number; student’s image; participation in officially recognized sports and activities; degrees or awards received. □ Please include my student’s information in the school directory. □ Do not include my student’s information in the school directory. Color Guard and/or Military Drill Team: In order for a student to be a member of Willamette Leadership Academy’s Color Guard and/or Military Drill Team students may not be on the “Do Not Photo” list, because these teams participate in public events which may be photographed by the media. My student may participate in the Color Guard and/or Military Drill Team, if eligible, and I understand that they may be photographed and the photographs may be publicized. Yes □ No □ *High School Students Only
17_18_new_student_enrollment_packet.docx