Plum SD Student Photo/Video Publicity Refusal
Please read this form very carefully before completing it so that the district can honor your intentions regarding publicizing your child.  

Plum Borough School District seeks to promote the positive accomplishments of our students actively. In many cases, our students' photos/videos appear in local media and publications produced by the District. If you do not wish for your child’s photo/video image to be used for inclusion in newspaper publicity, reproduced in school publications, or appear on the District’s website and social media communications, please complete and submit the form below. By not signing this form, you are releasing Plum Borough School District, its officers, agents, and/or employees from liability as a result of the use of this material.

Please complete the form below only if you DO NOT permit your child’s image/video and/or information to be used in public relations efforts. Otherwise, no action is needed.

Please complete the form below only if you DO NOT permit your child’s image and/or information.
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Email address *
Parent/Guardian Name: *
Student Name *
School Student Attends *
Student's Grade Level *
Formal Withdrawal from Publicity *
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