Technology Equipment Home-Use Checkout and Agreement
Edith Bowen Laboratory School                                                              

To the Parent or Legal Guardian:
If you would like your student to have home access to school-owned technology for academic use while enrolled at Edith Bowen Laboratory School (EBLS) please read and electronically sign this assumption of responsibility agreement.


Sign in to Google to save your progress. Learn more
Email *
Please enter the 6-digit ID Number on the white Utah State University bar code tag on the bottom of the device you are taking home here: *
Device type (Chromebook, iPad, etc.) *
Student First Name *
Student Last Name *
Grade Level *
Teacher Last Name *
Parent Agreement: You agree that as the student’s parent or legal guardian you will assume financial responsibility for any damage or loss of the equipment being borrowed, up to and possibly including its replacement cost (for example, missing keys are up to $25 to replace).  Removing the white Utah State University ID tag with the barcode and 6-digit number incurs a $25 fine--it creates a great deal of work on our end to re-inventory the equipment when tags are removed.  You and your student also agree to have your student follow the School Use of Technology Policy while using this equipment. You are responsible for managing internet access, filters, restrictions, and content while this device is in your possession.  You agree not to install or remove any apps or software on the equipment.  In the event of damage, loss, or theft of this equipment, you agree to contact EBLS as soon as possible to report the damage, and make financial arrangements for reimbursing the school for the cost of repair or replacement. You further agree to return the equipment in good condition along with any charging cords and/or accessories.  PARENT(S) enter your first and last name as an electronic signature (the date is stamped when you submit this form). *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Edith Bowen Laboratory School. Report Abuse