Opt Out Form

This is an Opt Out Form to opt out your son/daughter from the Reproductive Health and HIV Education at Wayland Union High School for the 2018-2019 school year.

Title

Student's First Name

Student's Last Name

My child will opt-out for the instruction indicated below.

List instruction Parent: please identify the instruction from which you would like your child excluded.

Opt out all future classes My child will opt-out of the instruction indicated below and all future reproductive health/HIV education classes. I will notify the principal of my child's school if I change my preference in the future.

List of Instruction

Date

School

Parent/Guardian Name

Parent Email

Signature By checking this box you are signing this form.

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