Directory Information Opt-Out Form

*Please complete a separate form for each child you are opting out for.*

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The Dayton Public School District protects a student’s educational records as confidential. Records will not be released to a third party without the parent/guardian’s prior written consent. However, the law does allow schools to release student “directory information” without obtaining prior written consent from the parent/guardian. 

Directory information includes the following:

  • Student’s name

  • Student's address

  • Telephone number(s)

  • Student’s date of birth

  • Student’s place of birth

  • Participation in officially recognized activities and sports

  • Student’s achievements, awards or honors

  • Student’s weight and height (if a member of an athletic team)

  • Major field of study

  • Dates of attendance (“from” and “to” dates of enrollment)

  • Date of graduation

  • Photographs and/or videos of students related to their participation in district and school events and activities, along with photographs and/or videos of students related to their participation in events open to the public, such as sporting events, theater productions, and community improvement projects. Students will also have their photo taken for their personal Student ID badge and for their school’s yearbook. (Photo/video distribution does not include video surveillance footage).

Please note: photographs and/or videos may be shared on district social media, website, newsletters, publications, or other media. Photos taken specifically for a student’s ID badge and portraits taken for the school’s yearbook would only be printed for those purposes and would not be shared elsewhere. 

Parents have the option to opt out of the sharing of any directory information within two weeks of receiving this notice, per district policy. 

You may also email directoryinformation@daytonpublic.com or call 937-542-3065 with any questions. Once the form is completed, the items you opt out of will be noted in the district’s Student Information System.

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Parent First Name *
Parent Last Name *
Parent Phone Number *
Parent Email Address (if applicable)
Student First Name *
Student Last Name *
Student ID Number *
Student's Current School *
Student's Grade Level *
For the following 11 questions, please only select the box if you wish to opt out of sharing that directory information item.
Student's name
Student's Address
Telephone number(s)
Student's date of birth
Student's place of birth
Participation in officially recognized activities and sports
Student's achievements, awards or honors
Student's weight and height (if a member of an athletic team)
Major field of study
Dates of attendance ("from and to" dates of enrollment)
Date of graduation

Photographs and/or videos of students related to their participation in district and school events and activities, along with photographs and/or videos of students related to their participation in events open to the public, such as sporting events, theater productions, and community improvement projects.

Students will also have their photo taken for their personal Student ID badge and for their school’s yearbook.

(Photo/video distribution does not include video surveillance footage).

By checking the box below, you certify that you are the legal parent/guardian of the student named above. *
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