Who is currently enrolled at Fort Cobb-Broxton Public School District, permission is granted to the Fort Cobb-Broxton Public School District and its Board members, employees, agents, servants and representatives to use this student�s name, photographic likeness, alone or in a group, in any Fort Cobb-Broxton Public School District publication, document, TV production, video or to release said names or likeness to any media outlets including, but not limited to, newspapers, magazines or TV stations for publicity and/or recognition purposes. Additionally, I extend permission to use this student�s name and/or photographic likeness, alone or in a group, on the official web site of the Fort Cobb-Broxton Public School District, Facebook, or a web site available through the official web site. The official web site is owned and maintained by the District as a service to the parents, students of Fort Cobb-Broxton Public School District and can be accessed and viewed at www.fcbmustangs.com. I release the Fort Cobb-Broxton Public School District, its Board members, employees, agents, servants, representatives and all organizations and individuals related the Fort Cobb-Broxton Board of Education�s Internet Network form any and all liabilities or damages that result from the use of this student�s name and/or photographic likeness as described above. This permission shall remain in effect unless revoked by me and communicated to the Fort Cobb-Broxton Public School District in writing.

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Photo Release Form: July 2011