Student Name ____________________________________

VIDEOTAPING RELEASE FORM

Parents/Legal Guardians:

Within the next few weeks your child’s student teacher will be videotaping teaching a lesson. The purpose of this experience is to improve instruction and evaluation skills of the student teacher.

Although the videotaping will focus on the teacher, it is possible that some students may appear in the tape. Please provide your permission below for your child to be in the videotape. Please sign the form and return it to your child’s teacher.

Thank you.

My child may participate in the classroom videotaping of his/her student teacher.

(Signature of parent or guardian)

(Date)

I request that my child not be included in the classroom videotaping of his/her student teacher.

(Signature of Parent or Guardian)

(Date)