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STUDENT USER AGREEMENT & PARENT PERMISSION FORM
As a user of the School District of Auburndale computers for Internet access, I hereby agree to comply with the district’s Internet Safety and Acceptable Use Policy – communicating over the network in a responsible fashion while honoring all relevant laws and restrictions. I understand that failure to comply with the policy may result in loss of Internet access and other disciplinary or legal actions.
Student Name (printed): _________________________________
Student’s Signature: ___________________________________ Date: ________________
As the parent or legal guardian of the student signing above, I grant permission for my son or daughter to access the Internet via the district network. I understand that this access is designed to enhance the curriculum and learning opportunities for students in the district. I understand that the School District of Auburndale has taken precautions to prevent access to inappropriate or harmful material, however, I recognize it is impossible for the district to control access to all objectionable material or the Internet. Therefore, I accept the responsibility for setting and conveying standards that my son or daughter should follow when selecting, sharing, or exploring information and media on the Internet. I understand that individuals and families may be held liable for actions taken on the Internet and that failure of my son or daughter to comply with the district’s Internet Safety and Acceptable Use Policy may result in loss of Internet access and other disciplinary or legal action.
Parent/Guardian Name (printed): ________________________________________________
Parent/Guardian Signature: _________________________________ Date: ______________
Address: ___________________________________________________________________
Home Telephone: ____________________________
[Once completed, please return this form to the school office.]
Approved: January 26, 2005
Revised: February 18, 2009
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