Survey - Opt Out Assertion

The following Parental Opt Out Assertion – Surveys allows parents, upon completion and submission of the form, to exclude their students from numerous School Surveys.  Below you’ll find a description of what these surveys are and how they’re used–AND your right to opt your student out.

Upon filling out the form below and clicking the submit button, an email with your completed form will be emailed to you.  The form and data is also emailed automatically to the email you designate for your school. Please double check the email you receive for accuracy.


I, [PARENT NAME], as a parent and/or legal guardian of [STUDENT NAME], a minor child, hereby exercise my right under the US. Constitution and laws of the State of Utah, to direct the upbringing and education of my minor child as follows:  

I DO NOT CONSENT to my child’s participation in any opinion survey, personal analysis, evaluation, questionnaire or any other form of data collection that reveals or attempts to affect, or references or relates in any way to my child’s attitudes, habits, traits, opinions, beliefs or feelings concerning: curriculum, political affiliations, religious beliefs or practices; mental or psychological conditions; sexual behavior or attitudes, sexual activity, sexual orientation; gender identity; or illegal, antisocial, self-incriminating or demeaning behavior.

For the avoidance of doubt, my child is not allowed or permitted to partake in any survey, including curriculum centric and/or opinion in nature, without parental written consent. 

Required Signature
                               (Parent or Guardian)