Validation Signature Page

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Pursuant to California Education Code 48982, the parent/guardian shall sign this notice and return it to the school. Signature on the notice is an acknowledgement by the parent/guardian that they have reviewed the Rules and Regulations on the Cathedral City High School webpage at www.catcityhigh.com (under Student Handbook at the right side of the home page) and the Palm Springs Unified School District - Parent Student Information Booklet (electronic copy) is available to all parent/guardians and students online at www.psusd.us. A hard copy of these handbooks can be obtained at CCHS upon request

Email *

Student ID# *

Students Grade (for 2020-2021 school year) *

9th

10th

11th

12th

12T (ATP)

Student's Last Name *

Student's First Name *

Student's Middle Name

Student's Date of Birth (mm/dd/year) *

YYYY

Student's Home Address (Address, City, State, Zip) *

Is this address different from the previous year?

Yes

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Student Use of Technology

Use of Technology Agreement

Student Use of Technology Agreement *

Yes, I give permission to issue an account for my child and certify that the information contained on this form is correct.

No, I DO NOT give permission to issue an account for my child and certify that the information on this form is correct.

Required

1 to 1 Pilot Chromebook Loan Agreement

1 to 1 Pilot Chromebook Loan Agreement *

Yes, I give permission to issue a Chromebook to my child and certify that I have read the 1 to 1 pilot loan agreement.

PSUSD Parent and Student Handbook Notification

PSUSD - Receipt of Annual Notification Parent and Student Handbook *

Yes, I have read and understand the information provided in the PSUSD Student Handbook regarding school and district policies

CCHS - Receipt of Annual Notification Parent and Student Handbook

CCHS - Receipt of Annual Notification Parent and Student Handbook *

Yes, I have read and understand the information provided in the CCHS Student Handbook regarding school and district policies.

Rules/Regulations/Policies- Code of Conduct pg 1

Rules/Regulations/Policies- Code of Conduct pg 2

Rules/Regulations/Policies- Code of Conduct *

Yes, I am familiar with the rules/regulations/policies and my student will follow as outlined.

Permission to be photographed: For my child to photographed while being involved in school activities. Resulting photographs, slides, videos and/or names may be used by the Palm Springs Unified School District at its discretion for publicity, news or presentations, including posting on district or school web pages. I agree to hold the Palm Springs Unified School District harmless from liability, compensation or ownership rights as a result of such use. *

I hereby grant permission

I DO NOT grant permission

CCGI Notification

CCGI Notification *

I have read the CCGI Notification and approve my student's participation

I do Not approve of my student participating in CCGI so I will be submitting a letter to the Principal.

Required

#1 Parent/Guardian Name *

#1 Parent/Guardian Relationship to student *

Father

Mother

Guardian

other

Required

#1 Parent/Guardian Address *

#1 Parent/Guardian Primary Phone Number *only type in numbers, DO NOT USE ( ) or / or - *

#1 Parent/Guardian email address * *

#2 Parent/Guardian Name

#2 Parent/Guardian Relationship to student

Father

Mother

Guardian

other

#2 Parent/Guardian Address

#2 Parent/Guardian Primary Phone Number *only type in numbers, DO NOT USE ( ) or / or -

#2 Parent/Guardian email address

Today's Date *

YYYY

A copy of your responses will be emailed to the address you provided.

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