PERMISSION FOR PUBLICATION IN JOURNAL

                                         ~ CANADIAN CHILDREN ~

                        PHOTOGRAPH/ FILM/ SLIDES/ VIDEO TAPE

I hereby grant permission for the publication of visual representations of the likeness of myself and/or my child/children in the journal of the
Canadian Association for Young Children, “Canadian Children”. These visual representations may be photographs, film, slides and/or video tape.

I understand that the name of my child/children will not be published for these or any other purposes without my express permission.

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Signature  (adult)____________________________________

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Address____________________________________

Telephone Number___________________________

Fax _____________________________ e-mail  _______________________________

Please return to:

Mabel F. Higgins, Editor CAYC Journal

Early Childhood Education, Lambton College

1457 London Rd., Sarnia, Ont.

N7S 6K4

Phone: 519 542 7751 ext 3273

Fax:     519 541 2423

Email: editor@cayc.ca