Channel 3 Video Footage Opt Out Form

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Channel 3 Video Footage Opt Out Form

Please complete this form ONLY IF you DO NOT want your child in any footage filmed for Better Connecticut (and any commercials that may produced from the filmed footage). Students names will NOT be used with any of the footage unless we specifically come to you to ask for permission. Students already on our "NO PHOTO" list will be automatically excluded from the filming.

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Your Name (Person Completing This Form) *

Your answer

Child 1 (LAST NAME, First Name) *

Your answer

Child 2 (LAST NAME, First Name)

Your answer

Child 3 (LAST NAME, First Name)

Your answer

Child 4 (LAST NAME, First Name)

Your answer

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