2023 - 2024 General Permission Form

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Please complete each section below for each of your students.

Email *

Student's Last Name *

Student's First Name *

Student's Grade in 2023 - 2024 *

Media Release - I give my permission for my student's image to be used for media purposes at the discretion of The Juniper School. This may be in the form of photographs, videos and social media, for general use and marketing use. *

Yes, I give my permission

No, I do not give my permission for my students photo to be used excpet within the school property (printed photos for in school display, etc.)

Walking and Transportation - I give my student permission to walk within 3 miles of the school and to utilize transportation services withing 30 miles of the school. Transportation may include busses, the trolley, bikes and other means of transportation. *

Yes, I give my permission.

No, I do not give my permission and I will contact the front office with my concerns.

Patricipation with approved partners of The Juniper School - I give my student permission to participate in activities with individuals that are considered staff, volunteers, independent contrators and service providers of The Juniper School. These individuals will be approved through the school or 9R District. *

Yes, I give permission

No, I do not give my permission and will contact the front office with my concerns.

Technology - I give permission for my student to use a wide variety of technology as part of their learning enviroment and experiences. I acknowlege that my student will be instructed on responsible , safe and acceptable use and care of technology in the school setting. By choosing yes below you are acknowledgeing that your child and your famiy are responsible for supporting these technology expectations. Technology devices/equipment will not be released for off-site use unless an additional release is signed. Purposeful and habitual samage or misuse of school property, above and beyond accidedntial causes, will be the responsibility of the student's family for repair. *

My student and I agree

No, I have questions before my student and I agree to this.

I give my child premission to view G rated material (movies etc..) that teachers use for educaional and reward purposes. Any materal rated PG will have a specific permission slip sent home from the classroom teacher. *

Yes

Parent's Name *

Parent's Phone Number *

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

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