‘. @ Willamette aha EDUCATION SERVICE DISTRICT PHOTO AND MEDIA RELEASE FORM Yes No (2 O11 give permission for photos, video or other media to be taken and displayed in newsletters, flyers, annual reports, websites or other publications for Willamette ESD, A Ceive permission for photos, video or other media to be taken and used for the wurpose Pe FP of educational enhancement of Willamette ESD staff, students, and families. Ma cia Velizi LEE Print Full Name Sunday, March 25 th, 2018 Date Oregon Migrant Education Program School, if applicable Photo and Media Release Form Updated March 3, 2015 Integrity + Innovation + Excellence + Partnerships 2611 Pringle Re SE + Salem, OR 97302 + 503568.5330 + wwwwesdora