Northland Pines Library Materials Opt Out Form

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This form allows a parent or guardian to select specific titles/materials they do not want their child to check out, or it can be used to prohibit their child from checking out titles/materials without pre-approved parent permission. A Parent or Guardian’s completion of this form may take up to 7 business days to process. Once processed, parents/guardians will receive a message in their Infinite Campus Inbox and will remain in place for the 2023-2024 school year.

Parent/Guardian First Name *

Parent/Guardian Last Name
*

Parent/Guardian Phone Number
*

Parent/Guardian Email
*

I certify that I have legal authority to make this decision for the student listed. *

YES

Student First Name
*

Student Last Name
*

Student Grade
*

I would like to restrict my student from the following:
*

Specific library materials (to be listed on next screen by title and author)

Access to any library materials without pre-approved parent permission

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