______________________ (shelter name) grants the Homeless Children's Education Fund permission to use the accompanying photographs, in whole or in part, on the HCEF website and on its printed materials. The parent or person acting as parent of a pictured child has approved such uses of that child's photograph. The shelter is responsible for keeping a record of parental/guardian consent.

HCEF certifies that it will not identify a child or parent by name nor identify the shelter where a photograph was taken.

Approved for the shelter by:

Name: _________________________

Position: _______________________

Shelter: ________________________

Date: __________________________

Received by HCEF:

Name: _________________________

Position: _______________________

Date: __________________________

This completed form is to be included with all photographs sent to HCEF, in whatever format (as CD images-the preferred format, e-mailed images, original photos).

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