Internet Symbols

Parents/Guardians fill out and return to school by Friday, October 30th only if you DO NOT want your child to participate.  If you did not get a form from your child you may use this one or contact your child's teacher. 


Opt-out of Artist Release and Use of School Network and Internet

(Parent signature required if student is under age 18)

Opt-out of Student Artist Release

I hereby do not assign and authorize the Putnam County School District the rights of and to any picture, photograph, video, or similar data used for or related to school-sponsored activities, learning experiences, and/or media events. I understand that if I opt-out, my child will not be included in pictures taken by school staff, media or agencies contracted by the school, nor will my child’s picture be part of a school yearbook, memory book, memory video, sports team, club, or any other medium. This does not include videotaping by security cameras in school or on school buses.

Parent/Guardian Name (please print) Signature Date

Student Name (please print) Signature Date

Opt out of Student’s Use of PCSD School Network and Internet

I have read and understand the guidelines for network and Internet use in the PCSD Student Code of Conduct, which includes use of the district’s software, computer networks, email accounts and the Internet service. I understand that this access is designed solely for education purposes and the school district has taken reasonable precautions to supervise Internet usage. However, I recognize that it is impossible for the District to control access to all information materials. With that understanding, I hereby do not give permission for my child to utilize the school network and internet services.


Parent/Guardian Name   _______________________________.            ________________________________    

                                                                              (please print)                                                         (Signature)

Student Name _________________________________________              Date _____________________________

                                                                             (please print)                                                               





PCSD Student Code of Conduct

www.Putnamschools.org