Media Opt-Out Form

Para completar este formulario en español, visite este enlace.

This form is only to be completed if you

do NOT want your child's picture included in any District media.

Student First Name *

Student Last Name *

School *

Grade *

Please ONLY check the box below if you wish for your child's picture to not be included in any District media. *

Comsewogue School District does NOT have permission to use my child's photograph in media publications that highlight the district's programs, including (but not limited to) newspapers, newsletters, internal displays, magazines, videos, television shows, social media and websites for the 2023 - 2024 school year.

Parent's First Name *

Parent's Last Name *

Today's Date *

Parent Signature *

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