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Elk Grove USD  |  E  6162.1  Instruction

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Use of Films, Videos, Digital Media Content, and Television For Student Viewing

Sample Letter for removal of grade 9-12 students from viewing "R" rated material and grade 6-8 grade students from viewing "PG-13" rated material.


Dear Parent/Guardian,

Our class is currently studying (Title of Unit). To enhance students' understanding of (Concepts, Topics, Themes), I am planning to show (Title and Description of Video) on (Date).

The video is rated (Rating) because of (Reason for Rating). It is important for classroom use because (Rationale). The curricular objectives addressed by the video include:

* (Curricular Objective)

* (Curricular Objective)

* (Curricular Objective)

Student Name Teacher

Please return by


I wish to have my child participate in the video viewing.

I DO NOT wish to have my child participate in the video viewing and request an

alternative assignment.

Parent Signature Date


version: May 16, 1994 Elk Grove, California

revised: June 6, 2006