MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01CA1379.85D65FF0" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Microsoft Internet Explorer. ------=_NextPart_01CA1379.85D65FF0 Content-Location: file:///C:/196B324E/websitepermission.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Linnville Lighthouse After School Program

Linnville Lighthouse After S= chool Program

6004 Linnville Road P.O. Box 762=

Newark, Ohio 43056

2009-2010 School Year

Website: www.stjohnsyouthcenter.com<= /span>

 

 

Childs Name: ___________________________________________________

 

 

___ I give permission for my child’s image (photograph) to be published online on the above listed website, provided that only his/her first name is used.

 

___ I do not give permission for my child’s image (photograph) to be used in the above listed website.

 

 

Parent’s signature: ___________________________________________________

Date: ________________________________________

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