Guardian Signature Date. I, the student, give permission for the use of text messaging, instant messaging and/or social media for school related matters. Student Signature Date NOTE: Federal law requires the District to monitor online activities of minors.
Guardian Signature Date. Parent Permission for World Wide Web Publishing of Student Work We understand that our daughter’s/son’s work (art, writing, etc.) may be considered for publication on the World Wide Web, a part of the Internet. No home address or telephone number will appear with such work. We grant permission for publishing on the World Wide Web as described above. A copy of all work published on the World Wide Web will be printed out and sent home with the student.
Guardian Signature Date. I, the student, give permission for publishing my work on the World Wide Web.
Guardian Signature Date. Consent for Emergency Medical Care I give consent for emergency medical care to be secured for the participant in the event of an emergency. I will be responsible for the emergency medical charges upon receipt of the statement.
Guardian Signature Date. Acknowledgement of Electronic Completion By electronically completing these acknowledgement(s), I swear that I am the parent/guardian of the participant, I have the authority to complete and execute this document, and the information contained in this document is accurate to the best of my knowledge. Parent/Guardian Signature Date Acknowledgement of Canopy Policy and Procedures Handbook I acknowledge that I have received and read the 2018-2019 Canopy Policy and Procedures Handbook and that I have reviewed it with my child. I understand the policies, procedures, guidelines, rules, and expectations outlined in the Handbook are only a summary of all Canopy policies and rules, and that I am subject to and must abide by all Giant Steps policies. I also understand that a violation of any of Giant Steps’ polices and rules may lead to disciplinary consequences. I further understand that the Handbook may be amended during the year without notice.
Guardian Signature Date. Consent for Community Transportation I give consent for the participant to participate in scheduled trips to and from the Lisle and Sugar Grove location, scheduled community outings and be transported via Giant Steps owned vehicles (including mini-vans, 10, 12, and 15 passenger vans), and shuttle buses), as well as contracted buses or vehicles, and/or walking while enrolled at Giant Steps/Canopy. I understand all such trips are under the supervision of Giant Steps staff members and that health and safety precautions are taken as appropriate. Parent/Guardian Signature Date Acknowledgement of Participant Absence Procedures I understand Giant Steps’ policy requiring me to notify Canopy each day that the participant will be absent. I understand that it my responsibility to notify the program in a timely fashion by calling (000) 000-0000, extension 3 as well as emailing the Program Manager and Service Liaison. I will leave the following information in a voicemail and email: the participant’s name, program name, and reason for the absence. I understand that it is also my responsibility to notify the participant’s transportation provider (e.g., bus company, cab company, etc.) if applicable each day that the participant is absent. Parent/Guardian Signature Date Consent for Use of Sunscreen/Bug Repellant I give consent for Giant Steps/Canopy staff to apply sunscreen and/or bug repellant to the participant when going out into the community (e.g. parks, playgrounds, swimming pools, walking and community trips, etc.,) with their discretion to the needs of the weather at the time of the community trip. Giant Steps/Canopy staff will make every effort to ensure that health and safety precautions regarding sun exposure are taken as appropriate, but they are not liable for sunburns or exposure for the participants. Authorization for Electronic Access Giant Steps has the ability to enhance each participant’s programming through the use of Giant Steps’ electronic network, including the Internet. Our goal in providing access is to promote diversity of and enhanced programming by facilitating resource sharing, innovation, and communication. Participants and/or their parents/guardians must sign this Authorization form annually. Giant Steps filters access on its electronic network to protect against pictures or videos that are obscene, pornographic, or otherwise harmful or inappropriate in the Canopy setting. However, it is impossible to guarantee the filtering of all such mater...
Guardian Signature Date. Section 4 : In case of an injury to my child while in the care, custody, or control of the School, I will hereby waive all claims against CCNS, its Directors, Facilitators, Teachers, Volunteers, and Members of all responsibility for any injury, loss, or damage which my child might sustain while participating in any CCNS activity. Parent/Guardian Signature Date CCNS Parent Consent Form CCNS assumes responsibility for the child once the parent(s) or guardian(s) make eye contact with the teacher and the child has been greeted. The School’s responsibility ends when the responsible adult arrives to pick up the child. All children must be signed in upon arrival and must be signed out at the end of the day. This is for liability purposes.
Guardian Signature Date. If the patient is physically or legally unable to sign and a guardian signed in place of the patient, please list: Guardian Full Name: _ Relationship to Patient:
Guardian Signature Date. □ I DO NOT authorize my child to take the District-issued computer out of the HUHS building and will direct them to check the computer in with the Technology Services Department on a daily basis. Hartford Union High School Student Network & Internet Acceptable Use and Safety Agreement For Parent and/or Guardian & Student Student I read and agree to abide by the Student Network & Internet Acceptable Use and Safety Policy and Guidelines (xxxx://xxx.xxxxx.com/hartforduhs-wi/search/policies/po7540.03.htm). I understand any violation of the terms, conditions set forth in the Policy, and Guidelines is inappropriate and may constitute a criminal offense. As a user of the Board's computers/ network and the Internet, I agree to communicate over the Internet and the network in an appropriate manner, honoring all relevant laws, restrictions and guidelines. Student Name (Print): Student's Signature: Grade: Date: Parent As the parent/ guardian of this student, I read the Student Network & Internet Acceptable Use and Safety Policy and Guidelines (xxxx://xxx.xxxxx.com/hartforduhs-wi/search/policies/po7540.03.htm) along with (xxxx://xxx.xxxxx.com/hartforduhs-wi/search/policies/po7542.htm) and have discussed them with my child. I understand student access to the Internet is designed for educational purposes and the Board, consistent with this purpose and the Children Internet Protection Act, has implemented technology protection measures that restrict and/or control student access to material on the Internet, which is obscene, objectionable, inappropriate and/or otherwise harmful to minors. However, I recognize it is impossible for the Board to restrict access to all objectionable and/or controversial materials, which may be found on the Internet. I will not hold the Board (or any of its employees, administrators, or officers) responsible for materials my student may acquire or come in contact with while on the Internet. Additionally, I accept responsibility for communicating to my child guidance concerning his/her acceptable use of the Internet - i.e., setting and conveying standards for my daughter/son to follow when selecting, sharing and exploring information and resources on the Internet. I further understand individuals and families may be liable for violations. To the extent that proprietary rights in the design of a web site hosted on the Board's servers would vest in my child upon creation, I agree to assign those rights to the Board. My signature below acknowledg...
Guardian Signature Date. Child's Name Date Please read the following release statements and indicate with an "x" the statements you approve. Sign at the bottom. Excursions: I give my child permission to go on Shoreline Cooperative Preschool field trips. Yes No Parents will be notified in advance of all field trips. Photographs: I give permission for my child to be photographed/ videotaped in scheduled preschool activities. Yes No Such photographs/ videotapes may be used by SCP for publicity or educational purposes. Regularly Authorized Adults: I authorize the release of my child to the following adults during the school year (please update during the year as circumstances change): Anyone who does not have permission to pick up my child:
