A501(c)3 organization supporting Environmental and Social Justice through innovation in the Arts 11 Santa Anna Drive Poughkeepsie, NY 12603 enjinnarts@gmail.com Student Name. Student Email Address example@example.com Student Age STUDENTS: Does En.j.inn Arts, Inc. have permission to use images, recordings, or other documentation of you or your work taken during the Sonic Spark class activities (including screen captures, should those events occur online) on our website or in promotional materials? YES, I give my permissionNO, I do not give my permission STUDENTS: If you answered "no" to the prior question, does En.j.inn Arts, Inc. have permission to use work you produced in or for Sonic Spark class on our website or in promotional materials, WITHOUT disclosing your name or using your image? YES, I give my permissionNO, I do not give my permission * STUDENTS: En.j.inn Arts, Inc. uses documentation of its classes for internal analysis and improvement of programming, as well as funding applications. Please indicate below if you prefer to shield your identity or have your image blurred in materials shared for these purposes outside of our organization. I have no preferenceI prefer to shield my identity/have my image blurred STUDENTS: Please type your full name here to indicate your agreement to the permissions statements above as . PARENTS: If your child is under 18 years of age, please type your full name here to indicate your agreement to the permissions statements above as filled out. PARENTS: email address example@example.com PARENTS: phone number Preview PDF Submit Should be Empty: Now create your own Jotform - It's free!Create your own Jotform
