|
Exhibit -Release of Student Information to PTA and Using a Photograph or Video Recording of a Student (Acrobat File)
Student_____________________________________________________ School Year _________________
The Family Educational Rights and Privacy Act (FERPA) requires District 41, with certain exceptions to obtain your consent prior to the disclosure of personal identifiable information from your child’s education records. In order to better protect the privacy of our families, parents are required, upon initial enrollment, to indicate their preferences (Yes or No) of how information is shared.
Pictures of Unnamed Students
Students may occasionally appear in photographs and video recordings taken by school staff members, other students, or other individuals authorized by the Building Principal. The school may use these pictures, without identifying the student, in various publications, including the school yearbook, school newspaper, and school website.
I authorize Glen Ellyn District 41 to use unnamed photos of my student as outlined above. Yes _____ No ____
Pictures of Named Students
Sometimes the school may want to identify a student in a school picture. For example, school officials want to acknowledge those students who participate in a school activity or who deserve special recognition.
In order for the school to publish a picture with a student identified by name, one of the student’s parents or guardians must sign the consent below.
I authorize Glen Ellyn District 41 to use named photos of my student as outlined above. Yes _____ No ____
PTA Directory and Yearbook–The District recognizes that parent organizations are an invaluable resource and partner to District schools. District 41 will release student name and address, parent telephone number, parent email address, student's grade, and teacher, for the creation of a PTA student directory to be distributed to school families. In addition, include the student's grade teacher, photo and information in the school yearbook.
I authorize Glen Ellyn District 41 to share information on my student with the D41 PTAs as outlined above.
Yes __________ No__________
Please complete and sign this form to allow the school to publish and otherwise use photographs and video recordings, with your child identified, while he or she is enrolled in this school.
Parent Name: ______________________________________ Date: _______________________________
Pictures of Students Taken by Non-School Agencies: While the school limits access to school buildings by outside photographers, it has no control over news media, other entities or parents that may publish a picture of a named or unnamed student. School staff members will be mindful of our policy and will not identify a student to these individuals
Revised: October 18, 2004. February 11, 2013, August 24, 2015, January 25, 2021
Adopted: October 18, 2004
Revisions Adopted: January 24, 2005, February 27, 2006, February 25, 2013, August 24, 2015, January 25, 2021
|
