604.06E2 Student Internet and Device Access Permission Form

Name:                                                                                           Graduation Year:

User Name:                                                                                  User Password:

Equipment-  Check-In                                                                Check-Out

Computer Asset Tag #:                                       Serial #:                                      Carrying Case          Power Supply & Cord

 

_______________________________________________________________   ______________________________________________                                                         Parent/Guardian Signature                                                                                      User Signature

________________________________________________________________.   _________________________________                                                                                 AdministratoSignature                                                                                         Date 

I understand that the laptop computer, tablet, and related equipment the above-referenced student is being issued is the property of the Spirit Lake Community School District. My student will return the laptop computer and/or tablet and any related equipment he/she is issued in the same condition in which he/she receives it, excluding normal wear and tear and unforeseen system breakdowns, i.e. hard drive failure, etc.

I understand that the District has insurance coverage that may cover the cost of repairs to the laptop. I understand that my student and/or I may be responsible for and/or assessed a fee for any damage or loss of any component of the laptop computer, tablet, and/or related equipment. In case of damage or loss, I agree that my student and/or I may be required to reimburse the District for and/or pay a fee for any damaged or lost component and/or equipment with components.

I recognize that although the Spirit Lake Community School District has taken measures to restrict access to controversial materials, it cannot guarantee that students will be protected from accessing any controversial materials during the student’s use of the District’s computers, computer-like equipment, computer network systems, and the internet. I accept full responsibility for my student’s use of the District’s computers, computer-like equipment, computer network systems, and the internet through the District in accordance with the terms, conditions, and guidelines as stated by the District in its policies and regulations and as set out in federal and state law. I relieve the Spirit Lake Community School District and its officers and employees, from any and all financial responsibility that may be incurred by my student’s use of the District’s computers, computer-like equipment, computer network systems, and the internet.

If a student already has an electronic mail address, he/she will not be permitted to use the address to send and receive mail at school, without permission from the technology department.

 

• My student may take his/her computer home with him/her.: _____ Yes _____ No
• My student may have access to internet.: _____ Yes _____ No
• My student may be issued or create an account for internet services, including but not limited to, a Google account.:_____ Yes ____ No
• I hereby give the District permission to publish my student’s work, picture, and/or first name on the internet through the District’s web site and/or other online forums._____ Yes ____ No

I am the parent or guardian of the above named student. I hereby certify that I have received, read, understand and agree to the Spirit Lake Community School District's Appropriate Use of Technology Policy.

____________________________________________________________________      __________________                                                                                                            Parent/Guardian Signature                                                                           Date

If you have consented to your child’s use of the District’s computers, computer-like equipment, computer network systems, and internet access, please have your child review and sign the following:

I have read the Spirit Lake Community School District’s Appropriate Use of Technology Policy and agree to abide by its provisions. I understand that violation of these provisions will result in the restriction and/or termination of my ability to use the District’s computers, computer-like equipment, computer network systems, and internet access and may result in further discipline up to and including expulsion and/or other legal action. I agree to be responsible for payment of costs incurred by accessing any internet services that have a cost involved.

I understand that the laptop computer, tablet, and related equipment I am being issued is the property of the Spirit Lake Community School District. I will return the laptop computer and/or tablet and any related equipment I am issued in the same condition in which I receive it, excluding normal wear and tear and unforeseen system breakdowns, i.e. hard drive failure, etc.

I understand that the District has insurance coverage that may cover the cost of repairs to the laptop. I understand that I may be responsible for and/or assessed a fee for any damage or loss of any component of the laptop computer, tablet, and/or related equipment. In case of damage or loss, I agree that I may be required to reimburse the District for and/or pay a fee for any damaged or lost component and/or equipment with components.

 

____________________________________________________________________    __________________                                                                                                              Student Signature                                                                                        Date