Student Image Opt-Out Form
Dear Parents/Guardians, 

The Phoenix Central School District often features images of students, usually identified by name, school and grade, in district publications (including, but not limited to the calendar, website, district newsletters, posters, and on the district’s Facebook, Twitter, and Instagram pages). We also share images of students with the local media (including, but not limited to newspapers and television stations and their websites and social media sites). 

If you DO NOT WANT your child’s image to be taken and used by the district or local media during the current school year, please complete and submit this opt‐out form.  Please be sure to include each child’s name and the school that they attends.  THIS REQUEST MUST BE MADE EVERY YEAR. Please note that school yearbooks are internal publications and are not subject to these restrictions. If you do not want your child’s name/image in the school yearbook, please contact your principal. 

If you DO NOT SUBIMIT this form, the district will assume that YOU GIVE PERMISSION for your child(ren) to be photographed as well as identified by name, school and grade in district publications for the current school year, as well as shared with the media. 

If unable to complete this form, as statged in the annual District Calendar.   Parents who do not want their child(ren) photographed for these purposes are asked to send a note to your child’s school principal. A simple written, signed note stating, “Please do not photograph my child(ren) {Student Name(s)} for use in publications and/or the web. The note may be delivered in person or mailed to your child’s school.

If you have questions, please contact Michael Foley at 315-695-1549 or mfoley@phoenixcsd.org
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Email *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Phone Number *

Please list the student(s), grade and school you wish to Opt Out.
Example:
Charlie Brown, 4, MAM
*
A copy of your responses will be emailed to the address you provided.
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