EmailMeForm
Student Name
*
First
Last
Parent/Guardian Name
*
First
Last
Phone
*
###
-
###
-
####
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Class/Camp Location
*
Everett
Issaquah
Online
Current Enrollment Session
*
Fall
Winter
Spring
Summer
A new form must be completed each session that media abstention is desired.
Class(es) for which student is enrolled
*
ZOOM/VIDEO RECORDING ABSTENTION for Private Use by Class Attendees: By entering parent/guardian's First and Last Name you opt that the name, photograph, likeness, video, and voice recording of the student indicated above for any video recording (such as Zoom recordings) to be used privately for the purpose of class only, be withheld.
MEDIA ABSTENTION: By entering parent/guardian's First and Last Name you agree to the following statement.
Please withhold name, photograph, likeness, video, and voice recording of the student indicated above for broadcast or publication from any and all media.
to:
