AGREEMENT FOR STUDENT PARTICIPATION IN THE

DISTRICT’S ELECTRONIC COMMUNICATIONS SYSTEM

Sponsoring Parent or Guardian

I have read the District’s electronic communications system policy and administrative guidelines.  In consideration for the privilege of using the District’s electronic communication system, and in consideration for having access to the public networks, I hereby release the District, its operators, and any institutions with which they are affiliated from any and all claims and damages of any nature arising from my child’s use of, or inability to use the system, including without limitations, the type of damage identified in the District’s policy and administrative regulations.

o     I give permission for my child to participate in the District’s electronic communications system and certify that the information contained on this form is correct.

o     I do not give permission for my child to participate in the District’s electronic communications system.

Signature of parent/guardian: ________________________________________________

Home Address: ___________________________________________________________

________________________________________________________________________

Date: ________________________   Home Phone Number: _______________________