Student_and_Adult_Release

Teaching Performance Assessment

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Student and Adult Release Forms

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•	Download Student Release Form
•	Download Adult Release Form
•	Download Administrator Release Form
•	Download Candidate Attestation Form

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Chapter 10 of the Candidate Handbook is dedicated to the Student and Adult Release Forms.

The following sample release forms are provided along with an explanation of the forms and your responsibility. For Assessing Learning and the Culminating Teaching Experience Tasks, your response will be based, in part, on actual students with whom you are working. You will submit the following forms that apply to your context:

Student Release Form – Required of every student whose work is submitted and/or who appears in the videotape.
Adult Release Form – Required for every adult who appears in the videotape.
Administrator Release Form - Signed by a district or school site administrator, this release states that signed release forms are on file at the school or district office.
Candidate Attestation Form – States that you have obtained all required release forms for the student work submitted and for each individual who appears in the videotape.

Your response to the task prompts includes the submission of instructional and assessment artifacts, samples of student work, and, for Culminating Teaching Experience Tasks, a videotape of you teaching a lesson. You are required to obtain a signed release form for every student and adult whose work you submit and/or who appears in the videotape. For adults, this includes, but is not limited to, classroom teachers, teaching assistants, parents, colleagues, or volunteers.

As a part of your task response, you must secure signed release forms. Print the student and adult release forms that follow and make copies. One release form per student and adult is sufficient for a task. But remember, you will be working with different students in Assessing Learning and the Culminating Teaching Experience Tasks, and you will therefore need to check to be sure that you have a release form for each student and adult.

The student and adult release forms are provided in both English and Spanish.

All forms for students and for adults must be signed and completed before any videotaping is conducted. You must submit the signed originals with your task responses and artifacts. Your task response will not be complete without the signed release forms. It is your responsibility to make and retain a duplicate set of the signed release forms.

As a matter of policy, some school districts request parent release forms at the beginning of every school year. Your school may already have parent release forms on file for your students. Check with your site administrator. It may not be necessary to secure an additional release form. The Administrator Release Form can be used to document school site or school district releases for your students. You will still need separate Adult Release forms for those adults who appear in the videotape.

If you do not have the permission of the parent or legal guardian to videotape a student, you must ensure that the student does not appear in your videotape. Also, if an adult has not given you a signed release form to videotape him or her, you must be certain that he or she does not appear in the videotape.

Permission for all students and for anyone who will be videotaped should be obtained as early as possible, so that you will have ample time in which to secure the release forms for students and adults. This can be accomplished by including a cover letter that explains the purpose of the performance tasks and videotape. In your letter, you will want to emphasize that the tasks are about your teaching practice, not about the students, and also to explain why the release forms are important to you.

Student Release Form (English and Spanish versions)

This completed and signed form is required of every student whose work is submitted with the task response and/or who appears in the videotaped lesson. Signed originals must be submitted with the task response.

Adult Release Form (English and Spanish versions)

This completed and signed form is required of every adult appears in the videotaped lesson. Signed originals must be submitted with the task response.

Administrator Release Form

This form may be used in lieu of individual student release forms if the school site or school district has a current videotape permission release form on file for every student who appears in the videotape or whose work you are submitting. If used, the signed original form must be submitted with the task response.

Download a copy of the Administrator Release Form

Candidate Attestation Form

This form verifies that you have obtained signed release forms for all individuals who appear on the videotape and/or whose work you submit as a part of your assessment response. You must complete, sign, and submit this form with your task responses for Assessing Learning and the Culminating Teaching Experience Tasks.

Download a copy of the Candidate Attestation Form

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