J4TH Video Surveillance Release Form

VIDEO SURVEILLANCE RELEASE FORM
Child's Name*
Child's Date of Birth*

MonthDayYear
Date
Just 4 Kids Preschool provides a secure environment for your child. In our attempt to protect the welfare of your child, and our staff, video cameras are in all classrooms, the offices, the staff room, and outside patios. Each camera will record your child’s daily activities and that of our staff. I understand that the use of video cameras at Just 4 Kids Preschool to record my child’s daily activities are solely for the preschool’s use only. In addition, I understand that this condition is necessary for my child’s enrollment at Just 4 Kids Preschool.
I have read and understand this agreement and I am over the age of 18. I am the parent or guardian of Name of Child*, and I have the legal right to consent to and do consent to the terms and conditions of this release.
Parent / Guardian Name*
Date*

MonthDayYear
Date
Parent / Guardian Email*
You will receive a copy of this PDF you just filled out thru this email address.
Parent / Guardian Signature*

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VIDEO SURVEILLANCE RELEASE FORM