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

Bethel Park School District seeks to actively promote the positive accomplishments of our students. In many cases, photos of our students appear in local media and in publications produced by the District. If you do not wish for your child’s photo image to be used for inclusion in newspaper publicity, reproduced in school publications, or to 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 Bethel Park 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 and/or information regarding his or her accomplishments to be used in public relations efforts. Otherwise, no action is needed. We are anxious to publicize the many achievements of our students and would like to involve your child when appropriate.

If you have any questions about the form, please contact the District’s Office of Communication.

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Email *
Parent/Guardian Name:
Parent/Guardian Email:
Student Name
School Student Attends
Student's Grade Level
Formal Withdrawal from Publicity *
Formal Withdrawal from Publicity *
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