Name of Student: ____________________________
School: ____________________________________
Date: ______________________________________
Teacher or Team working with child:
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I give permission to have my child, __________________________, to be video-recorded by the person(s) or team taking the course: Introduction to Deaf-Blindness, for the purpose of completing his, her, or their Final Project. I understand that he, she, or they will be completing a written description of the communication intents produced by my child on the video recording. (The written description and video recording will be reviewed by the instructors for a grade.) I further understand that the video recording will not be distributed or viewed by others outside of the course without my written consent.
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Parent(s) Signature(s)
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Date Signed