2025-26 Media Waiver Opt-Out Form

2025-26 Media Waiver Opt-Out Form

Only fill out this form if you wish to opt-out of Somersfield's media and publications for the academic year of 2025-26. One form per student.
Student's Full Name*

First NameLast Name
Student's Class*
I do not consent for my child's image or voice to be used for Somersfield Academy:*

Social media (Somersfield generated content or sharing external content ie newspaper articles or posts from outside organisations)Press releasesPublications (ie small circulation publications such as the Annual Report, Strategic Plan etc)Advertisements (digital and print ads)Other (please explain below)
You selected “Other” — we’d appreciate it if you could briefly explain in the text box below.
Please upload a photo of your child (this will only be used for reference)

Cancelof
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Comments
We work hard to ensure names are spelled correctly, permissions are honoured, and everyone is represented with care and respect. But mistakes can happen.

If you notice anything that needs correcting, please let us know.

You can reach us at marketing@somersfield.com, 535-8700, or 239-3367. We’ll do our best to make it right.
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