COFFEE COUNTY SCHOOL SYSTEM SIGNATURE AGREEMENT FORM
STUDENT ACCEPTABLE USE AND INTERNET SAFETY POLICY AND STUDENT HANDBOOK ACKNOWLEDGEMENT FORM
This Parent/Student Handbook and Student Acceptable Use and Internet Safety Policy contain valuable information for you and your student to ensure success in the school environment. This success is dependent upon mutual respect and clear understanding of rights and responsibilities. Please read carefully each statement below and sign on the appropriate lines to indicate your wishes.
PLEASE COMPLETE THE FORM AND RETURN IT TO SCHOOL.
STUDENTS - Every student, regardless of age, must read and sign below:
I have read, understand and agree to abide by the terms of the foregoing Student Acceptable Use and Internet Safety Policy provided in this Student Handbook. Should I commit any violation or in any way misuse my access to the school system's computer network and the Internet, I understand and agree that my access privilege may be revoked and school disciplinary action may be taken against me.
Student Name (PRINT CLEARLY) Student ID# Home Phone Address
Student Signature Date
User (place an "X" in the correct blank): I am 18 or older _____ I am under 18 _____
If I am signing this policy when I am under 18, I understand that when I turn 18, this policy will continue to be in full force and effect and agree to abide by this policy.
PARENTS - To be read and signed by parents or guardians of students who are under 18:
- As the parent or legal guardian of the above student, I have read, understand and agree that my child or ward shall comply with the terms of the school system's Student Acceptable Use and Internet Safety Policy, provided in this Student Handbook, for the student’s access to the school system's computer network and the Internet. I understand that access is being provided to the students for educational purposes only. However, I also understand that it is impossible for the school to restrict access to all offensive and controversial materials and understand my child’s or ward’s responsibility for abiding by the policy. I am therefore signing this policy and agree to indemnify and hold harmless the school and the school system against all claims, damages, losses and costs, of whatever kind, that may result from my child’s or ward’s use of his or her access to such networks or his or her violation of the foregoing policy. Further, I accept full responsibility for supervision of my child’s or ward’s use of his or her access account if and when such access is not in the school setting. I hereby give permission for my child or ward to use the building-approved account to access the school system's computer network and the Internet.
- I understand that my student is responsible for all of the policies and procedures contained in the handbook.
- I have received a copy of the Attendance Policy and understand that I can be charged with a misdemeanor if my student obtains the sixth (6) unexcused absences. Parents, guardians, or other persons with control or charge of children are required to enroll and send students to school. Any student subject to compulsory attendance laws who has five or more unexcused absences shall be considered truant and subject to system discipline policies and procedures.
- I understand that certain information (name, date of birth, participation in clubs and sports, awards, photographs, etc.) is considered Directory Information and may be released to the media (local newspapers) for publication.
- I acknowledge that all clubs and extracurricular activities with related information are listed in this handbook and have been made available for review. Any new clubs or activities formed during the school year will require that information is sent home and that I must grant permission for my student to participate. I understand that if I wish for my student to "opt-out" of clubs and extracurricular activities I will contact the front office.
____I refuse permission for the release of any Directory Information
Parent/Guardian Name (PRINT CLEARLY) Address Home phone Parent/Guardian Signature Date
Student Signature Date
Legal References: Children’s Internet Protection Act of 2000 (H.R. 4577, P.L. 106-554)
Communications Act of 1934, as amended (47 U.S.C. 254[h], [l])
Elementary and Secondary Education Act of 1965, as amended (20 U.S.C. 6801 et seq., Part F)
PLEASE BE SURE TO READ, COMPLETE THIS FORM, SIGN AND RETURN TO SCHOOL TOMORROW.