ROCKINGHAM COUNTY SCHOOLS PUBLICITY DECLINE FORM

ROCKINGHAM COUNTY SCHOOLS PUBLICITY DECLINE FORM

511 Harrington Highway Eden, North Carolina 27288 ROCKINGHAM COUNTY SCHOOLS PUBLICITY DECLINE FORM School: _____________________ Homeroom Teacher:__...

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511 Harrington Highway Eden, North Carolina 27288

ROCKINGHAM COUNTY SCHOOLS PUBLICITY DECLINE FORM School: _____________________

Homeroom Teacher:__________________

Rockingham County Schools is making a concentrated effort to promote the positive activities, honors, and work of our staff and students. This includes working with the local newspapers, radio, and television stations and also developing our own publications. These publications include information, likenesses, and images, which may appear on the district web site as well as in other publications. As we go about this project there will be opportunities for various students to be interviewed and/or photographed and identified by name and classroom or school. However, we understand that some parents may request that we do not identify their child(ren). Please fill out the form below only if you do not want your child in forms of publicity. Please note, however, that your child’s image or likeness may appear in occasional candid photos without any type of name identification and the use of these candid photos of your child is permissible. This photo release form does not apply to photographs taken during extra-curricular activities. Students who attend extracurricular activities forfeit their rights to retain authority over the publication of photos taken. Please fill out the form below only if you do not want your child in forms of publicity. (Please print. Use a separate form for each child) Student Name: ____________________________________

Grade: _______

Parent/Guardian Name: _________________________________________ I DO NOT want my child’s picture/work used in: Local Newspaper

School Newspaper

Yearbook

Video/Slide Show

Literary Magazine

RCS Publication

RCS Newsletter

School Website

District Website

Parent/Guardian Signature: ______________________________________ Date: ________________________________________ This form will be kept on file at your child’s school. If a situation arises that may change your child’s status regarding publicity, please notify the school in writing as soon as possible. Revised 01.11