This is an Opt-Out Form.
ELMIRA CITY SCHOOL DISTRICT
PHOTO/MEDIA RELEASE OPT-OUT FORM
Note: Complete this form ONLY if you do NOT give permission for your child to appear in media or school publicity images/video. This form only applies to the current school year and is required to complete annually by parents who wish to opt their student(s) from media.
Local newspapers, television news, and radio stations often attend school events or interview students to provide coverage of our schools and students. Community organizations and partners who provide services to our schools also visit our schools and may want to use photographs/videos and/or your child’s name in publications and informational materials. If you grant Elmira City School District permission to use your child’s name and likeness in this manner, nothing is required by you.
If you wish to DENY PERMISSION for your child’s inclusion in media coverage, partner publications, or even District publications, please submit this form to the Main Office at your child’s school. This notice includes denying permission for your child to be photographed, filmed or interviewed by the media or community organizations and partners. You request that such information will *not* be published in any form for use in print, television, film, or Internet publications (including social media, District website, etc).
PLEASE NOTE – This form does not apply to students involved in sporting events or school plays, or to inclusion in yearbook photos. School officials cannot prevent the media from photographing or interviewing students off school property. If you do not wish to have your child’s photo in the yearbook, please contact your child’s school principal directly.
Please sign and return this form to your child’s school only if you DO NOT want your child’s image/name released. Do not return this form if the District has permission to release your child’s photo/name.
IF ALLOWING PERMISSION, do nothing.