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New Canaan Public Schools Opt Out Form (Students Grade 8 – 12) PUBLICATION OF STUDENT IMAGES (PHOTO AND VIDEO) AND STUDENT INTELLECTUAL PROPERTY AND Access to ICT Resources Please complete the form below and return to the Director of Digital Learning if you choose to opt out of either publication of student images and student intellectual property rights or your child’s access to ICT resources. Director of Director of Digital Learning New Canaan Public Schools 11 Farm Road New Canaan, CT 06840 Opt Out of Publishing of Student Images and Student Intellectual Property • I DO NOT want my child or representative of the New Canaan Public Schools to transmit or publish images of my child (photo or video) and his/her intellectual property under the guidelines of the Digital Publishing Guidelines. School: Grade: Student Name: Parent or Guardian (please print):

Home Phone:

Signature:

Date:

Address: This agreement is valid for the

school year only.

ICT Opt Out Form If you DO NOT want your son or daughter to have ICT resource access, please return this form to: School:

Grade:

Name of Student Street Address Home Phone Parent or Guardian (please print): Parent Signature

Date:

This agreement is valid for the

school year only.

As the parent or legal guardian of the student named above, I do not grant permission for my son or daughter to access ICT resources as provided by New Canaan Public Schools. Reference: BOE Policies 4620, 4625, and 6141 Last Revision Date: 11/2014