Hawlemont Regional School District Acknowledgement and Permission Form

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Please read and fill out completely, submitting within 10 days of receipt. You can access our handbook in its entirety on our website or contact the office for a paper copy.

Thank you!

Student(s) Name(s) *

Student(s) Grade(s) *

Required

We have received, read, and reviewed the Handbook. *

Yes

We have received, read, and reviewed the Bullying Prevention and Intervention Plan contained in this Handbook. *

Yes

We have received, read, and reviewed the Transportation Policy contained in this Handbook. *

Yes

We have received, read, and reviewed the Internet Acceptable Use and Safety Policy contained in this Handbook. *

Yes

We have received, read, and reviewed the Sexual Harassment Policy contained in this Handbook.
*

Yes

We have received, read, and reviewed the Drug and Alcohol Policy contained in this Handbook.
*

Yes

I give permission for my child(ren) to use the Internet at School.

Yes

Other:

I give permission for my child(ren)’s picture(s) and first name(s) only to be posted on district web pages and social media platforms.
*

Yes

Other:

I give permission for samples of my child(ren)’s school work and first name(s) only to be posted on school web pages.

Yes

Other:

I give permission for my child(ren)’s picture(s) and first name(s) only to be included in press releases.

Yes

Other:

I give permission for my child to participate in organized walks in the neighborhood of the school with staff .

Yes

Other:

My child has permission to walk to the river and wade in the water with Hawlemont staff supervision.

Yes

Other:

My child has permission to participate in all class and school outings.

Yes

Other:

Guardian Signature *

Date *

YYYY

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