2023-2024 Mid-Year Cell Phone/Smart Device Consent Form

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Date *

YYYY

Name of Parent(s)/Guardian(s) completing this form. (By completing this form, I am giving full consent in lieu of a signature.) *

Name of Student *

Grade Level: *

Kindergarten

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Grade 8

I/We have read and understand the 2022-23 St. Patrick School Cell Phone, Smart Device and E-Reader Policy. I/We agree to support and abide by all policies and procedures contained therein. *

I agree.

I understand that St. Patrick School is not responsible for any cell phone, (wrist) smart device, or e-reader that is lost or damaged while on campus. I/We understand that requesting to bring a cell phone/smart device/ E-reader to school places liability for the cell phone/smart device on the student and parents. *

I understand.

I/We give permission for my child to have a cell phone/smart device on campus. The cell phone/smart device will be held by the homeroom teacher daily, per the Cell Phone/Smart Device/E-Reader Policy. Please note: St. Patrick School does not recommend bringing a cell phone on campus. *

Yes, I give permission.

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