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7-12 Parental Permission/Signature Page
2021-2022
I have read the referenced pages and agree to all explanations and rules set forth in them.
One form per student. Please fill out for each 7th-12th grade student.
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* Indicates required question
Student Name
Your answer
Student Grade
*
7th
8th
9th
10th
11th
12th
Handbook Acknowledgment (Students and Parents)
*
Accept
Deny
Personally Identifiable Information (Check Only One)
*
You may publish my child's picture or work in any form.
You may not publish my child's picture or work on the internet
You may not publish my child's picture or work in printed material.
You may not publish my child's picture or work on the school TV system.
Acceptable use of Computers or Networks (students and Parents)
*
Accept
Deny
iPad/Chrome Book Loan Agreement (Students and Parents)
*
Accept
Deny
Student & Parent Consent (Students and Parents)
*
Accept
Deny
List Activities you do NOT want your student to participate in: (Skip question if they have permission to participate in all activities)
Your answer
Athletic Participation Parent Consent Form. (Students and Parents)
*
Accept
Deny
My student may compete in all sports EXCEPT: (Skip question if they have permission to compete in all sports)
Your answer
Activity Participant Pledge of Sportsmanship (Student Only)
*
Accept
Deny
Non-Athletic Activity Participation Parent Consent Form. (Students and Parents)
*
Accept
Deny
Authorization for Release of Information and Consent to Treat
*
Accept
Deny
Notice of Information Privacy Practices
*
Accept
Deny
Medication Permission Form-- Needs to be filled out and turned into office-- If needed
Parent/Guardian Electronic Signature (Please type your name if you agree to the terms set out in these documents)
*
Your answer
*
Option 1
*
Option 1
Student Signature (Please type your name if you agree to the terms set out in these documents)
*
Your answer
Date
*
MM
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DD
/
YYYY
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