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Do you have children attending public district or charter schools within the Kansas City Metro Area? If yes, specify what number of children.

What school(s) does your child/children attend? (No children, no worries. Please write "zero" if you have no children currently in attendance).

Images will be collected occasionally during the SpEd Power Academy. These images are used primarily for marketing and outreach purposes for the Parent Power Lab. Your imagery will not be sold or otherwise conveyed to a third-party entity for any purpose whatsoever.

-I acknowledge that I have been informed that the Parent Power Lab will be collecting images throughout the SpEd Power Academy. -I grant permission to use my image and likeness captured during SpEd Power Academy activities. -I understand that I will not receive any royalties or other payment from the use of captured imagery. -In addition, Parent Power Lab agrees that they will not sell images to any other organizations or individuals. -I have read and understand the statements above. -I certify that I am older than the age of 18 and able to enter this agreement. -I certify that I am the parent or legal guardian of any minor children identifiable in these photos, videos and recordings and that they may be included. Please write your name below to acknowledge that you have viewed and consent to the statements above:

Additional questions or concerns:

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