Publicity Denial Form 2020-21

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COMPLETE ONLY IF YOU DO NOT WANT YOUR CHILD PHOTOGRAPHED/ VIDEOTAPED.

Email *

Student's Name *

School *

Home Room Teacher

Though this year has started out in comprehensive distant learning, opportunities may occasionally arise for your child to be photographed and/or videotaped during a virtual class, at school, school activities, or for staff development/educational purposes. Use of such photographs/video includes, but is not limited to: school or school district publications and websites, news media stories on school programs or activities, slide shows or videos. When these opportunities occur, the student’s image may be accompanied by his/her first and last name, classroom work, and information regarding the student’s participation in a program or activity.

If you DO NOT want your child’s photograph to be published for any or all of the uses described, please confirm by checking the box or boxes below.

DO NOT publish my child’s photo in school or school district publications, slideshows or videos; on the school or school district website; or in news media stories about school programs/activities.

DO NOT publish my child’s photo in school yearbook. By checking this box, I understand that my student’s photo WILL NOT be included in the school yearbook.

IF THIS FORM IS NOT RECEIVED BY YOUR CHILD’S SCHOOL, IT IS UNDERSTOOD THAT USE OF YOUR CHILD’S PHOTO IS PERMITTED.

Parent/Guardian's Name *

Phone Number

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