ROCKINGHAM COUNTY SCHOOLS

PUBLICITY DECLINE FORM

School: __________________________________________________

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.

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

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.