2026-2027 HES 3rd Grade Community Agency Opt-Out Form

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Dear WSD Family,

Throughout the duration of the academic year, the Wentzville School District partners with community agencies that specialize in providing students, families, and educators with preventative education. Agency presenters are credentialed, coordinated throughout the District, and under the supervision of building administrators. Presentation topics are targeted toward specific grade levels. All students will participate in each program, unless you choose to opt your child out of the lesson(s). The program that is scheduled for 3rd grade is listed below:

Program: Violence Prevention

Topic: Bullying and Teasing

Community Agency: Compass Health

This objectives for the program are as follows:

1) Youth will report knowing when to physically get away from a potentially violent or threatening situation.

2) Youth will be able to recognize at least two signs of inappropriate responses to anger within themselves.

3) Youth will be able to recognize at least two signs of bullying behaviors.

4) Youth will be able to appropriately verbalize their feelings of being peer pressured to both peers and adults.

5) Youth will be better prepared to seek adult support when faced with a potentially violent situation.

The presentation is based on James Stanfield's "Be Cool" Program. The language used is universal throughout the various grade-level programs. The program concludes with a brief survey to assess understanding of the content that was shared.

Notice of when the program will be presented will be provided by your child's school. If you do NOT wish for your child to participate, please click the box below. (By leaving the box unmarked, your child will be permitted to participate.)

I do NOT wish for my child to participate in Violence Prevention: Bullying and Teasing.

Program: Internet Safety

Topic: Sexual Abuse Prevention*

Community Agency: The Child Center

The Internet Safety Program is designed to develop students' understanding of ways to use the internet safely. It will increase awareness of safety, boundaries, and what children can do if they feel uncomfortable online. The presentation concludes with a brief survey to assess understanding of internet safety.

*Please note that in accordance with section 170.045 RSMo., school districts are required to provide age and developmentally appropriate sexual abuse prevention education to students. Under Missouri Law, this education will include the following components, at a minimum:

1) Instruction providing students with the knowledge and tools to recognize sexual abuse,

2) Instruction providing students with the knowledge and tools to report an incident of sexual abuse,

3) Actions that a student who is a victim of sexual abuse could take to obtain assistance and intervention, and

4) Available resources for students affected by sexual abuse.

I do NOT wish for my child to participate in Internet Safety: Sexual Abuse Prevention.

Student's First Name: *

Student's Last Name: *

Teacher's Last Name: *

A copy of your responses will be emailed to the address you provided.

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