I just received this "Opt out Form" from a parent. I was wondering if
anyone else had seen it and just how your school and district handle it.
____________________________________________________________________________
____
PARENT/STUDENT
OPT OUT
FORM
I/We, parent(s) of _____________, have chosen NOT to delegate our
responsibility in the following areas of education or health to any teacher,
administrator, guest speaker, medical practioner or agent:
1. Family planning or non-emergency health services, referrals
of programs
2. Sex education, family living, alternative lifestyles, or
diversity
3. AIDS OR SEXUALLY TRANSMITTED DISEASES
4. "Decision Making" that is not directly related to academic
studies
5. Teenage Health Consultant Programs
6. Homosexuality and/or Multiculturalism or Globalism
7. Affective education (feelings) or "values" training.
8. Population control or overpopulation (Large family bias)
9. Suicide, euthanasia, dying or death
10. Self esteem, opinion, attitude or value surveys
11. Environmentalism that is biased or has New Age/One
World/Globalize as an
agenda association.
12. Drugs and alcohol abuse or prevention.
Because I/We , as parent(s)/guardian(s) of _______________ provide for
the above listed training, I/We,
1. Request that he or she be sent to the library with an
academic assignment
that these topics are to be discussed in class.
2. Request to be notified weekly if our request(s) require more
than one hour
of alternative library study per week.
3. Request that there be no referral for any prevention, intervention or
after
care program or services of any organization or agency (whether
internal
or external), even if the law might allow treatment without parent/
guardian consent.
4. Request that we be contacted prior to any disciplinary action or
counseling; collecting of data, using psychological methods or
otherwise
various techniques for personal interview, interrogation or
questioning.
5. Defer permission for all emotional wellness, psychological, guided
imagery, health, or other evaluations or screenings.
6. Do not authorize the use of his/her Social Security Number for any
reason,
and insist that it be removed from any documents on which the school
and/or administration may have it listed (the Social Security Act, 42
does not grant schools use authorization.
7. Be contacted immediately with any academic, behavioral, or health
concerns needing our attention.
Thank you for your cooperation. Most Respectfully,
Parent/Guardian
Parent/Guardian School
Reprsentative.
(Submit OPT Out form in duplicate, retaining one sighned copy as record)
P.I.E. INC., Palm Desert, CA 92261, a "Non-Profit Corp.
David N. Triche, LMT,
UTLA Chapter Chair
Emerson Middle School
1650 Selby Ave.
L.A. CA 90024
310-470-0616 Phone and Fax
dtriche@lausd.k12.ca.us
Web Page http://www.lausd.k12.ca.us/Emerson_MS/Triche/Index.htm
"Are there Blacks in Brazil?"
-Der Spiegel, May 19, 2002
http://gwbush.com/copies/trans.html
"Rarely is the question asked: Is our children learning?"
-Florence, S.C., Jan 11, 2000
"The legislatures job is to write law. It's the executive branch's job to
interpret law."
-Austin, Texas, Nov. 22, 2000
"They want the Federal Government controlling Social Security like it's some
kind of Federal Program
St. Charles, M0., Nov. 2, 2000
""It's clearly a budget. It's got a lot of numbers in it."
-Rueters, May 5, 2000
"We ought to make the pie higher."
South Carolina Republican Debate, Feb. 15, 2000.
George W. Bush, President of the United States of America
Graduate of Yale and Harvard
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