PARENT/TEACHER PERMISSION FORM
I understand and will abide by the above terms and conditions for technology usage. I further understand that any violation of the above regulations is unethical and may constitute a criminal offense. Should I commit any violation, my access privileges may be revoked, school disciplinary action and/or appropriate legal action may be taken.
Student Signature_________________________________ Student Age_________
Student Full Name (please print)_________________________________________
Home Telephone__________________ Grade__________ Date_______________
As the parent/guardian of this student, I have read the terms and conditions for technology usage. I understand that this access is designed for educational purposes and Dallas School District has taken available precautions to eliminate controversial material. However, I also recognize it is impossible for Dallas School District to restrict access to all controversial materials and I will not hold them responsible to materials acquired on the network. Further, I accept full responsibility for supervision if and when my child’s use is not in a school setting. I hereby give permission to issue an account for my child and certify that the information contained on this form is correct.
Parent/Guardian Signature___________________________ Date_______________
Parent/Guardian Full Name(please print)___________________________________
As the sponsoring teacher of this student, I have read the terms and conditions and agree to promote this agreement with the student. Because the student may use the network in context of another class, I cannot be held responsible for the student use of the network. I do agree to instruct the student on acceptable use of the network and proper network etiquette.
Teacher Signature_________________________________ Date_________________
Teacher Full Name (please print) __________________________________________
Please return this signed form to the system administrator. When your account has been established, your sponsoring teacher will contact you. Thank you for your interest and support of this exciting resource in the Dallas School District.