Verizon MiFi Replacement Agreement
Please complete the following agreement for each child in the household utilizing a school provided hotspot.  
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Student First Name *
Student Last Name *
Student Identification Number (SID)
School: *
Parent/Guardian Name: *
Parent/Guardian Email Address:
As the parent/guardian of the above named student, I have read and understand that Verizon and the U.S. Consumer Product Safety Commission(CPSC) has recalled the Ellipsis Jetpack mobile hotspot models MHS900L,MHS900LS and MHS900LPP which was provided to my student for learning. Based on the information provided in the Important Device Notice from Verizon Wireless About Your Child’s Mobile Hotspot document, I have the following options:    
Option 1:  I have decided to return* my student’s Ellipsis Jetpack to his/her school and wait to receive a replacement as soon as one is available. I understand that there may be a period where my student will not have a hotspot for Internet access and that my school system is making every effort to provide my student with a replacement as quickly as possible.
Option 2:  I have decided to allow my student to continue to use the Ellipsis Jetpack during the interim period which began with this notice and continues until a new replacement device is provided. I will ensure my student strictly adheres to the intermediary steps and suggestions provided by Verizon. I further acknowledge that as the parent/guardian of the above named student, I am assuming all risks and liability for continued use of the recalled Ellipsis Jetpack mobile hotspot provided by the Iberia Parish School District to my student for learning.
Select an option: *
* If you have chosen option 1, please return the hotspot to your child's school by Tuesday, May 4, 2021.
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