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Sample Emergency Card Opt Out Forms


CLICK HERE TO DOWNLOAD THE SAMPLE OPT OUT FORMS AS A PDF

In an excellent example of how the method for informing students of their right to Opt Out can significantly increase Opt Out rates, the Pajaro Valley Unified School District and Santa Cruz City Schools made it clearer and easier for parents to opt out their kids by adding the following text to their Emergency Information Card:

RELEASE OF INFORMATION TO MILITARY RECRUITERS:
Your child's name, address and phone number WILL be released to military recruiters UNLESS you specify here that you want this information withheld.

__ DO NOT release my child's directory information to military recruiters without my prior written consent.


Or, if you want to have an Opt Out form that also lists other groups besides the military, you can use this form that a school board member drafted:

RELEASE OF INFORMATION TO MILITARY RECRUITERS OR OTHERS:
Your child's name, address, and phone number WILL be released to military recruiters or other possible requesters such as news/media, institutions of higher education, employers/potential employers, etc. UNLESS you specify here that you want this information withheld.

__ DO NOT release my child's contact information to military recruiters without my prior written consent.

__ DO NOT release my child's contact information to the following without my prior written consent: __________________________________.


CLICK HERE TO DOWNLOAD THE SAMPLE OPT OUT FORMS AS A PDF