Parent-Student Handbook Acknowledgement & Media Release Survey

Parent-Student Handbook Acknowledgement Form and Media Release

Please complete an Acknowledgement Form for each student.
Family Signature of Receipt & Acknowledgment

By signing below, you are agreeing to the policies and procedures of the Parent-Student Handbook including, but not limited to:

·        Registration Requirements

·        Academic Expectations

·        Report Cards & Grading

·        Attendance

·        Non-Compliance

·        Work Samples

·        Technology Usage

·        Testing & Assessments

·        Behavioral Expectations

·        Instructional Funding

·        Academic Integrity
Student Name

First NameLast Name
I give permission to use pictures of the student and/or video or audio on the school's website:
I give permission to use pictures of the student for the school yearbook:
I give permission to use school work produced by this student for school purposes:
Parent Name

First NameLast Name
Email
example@example.com
Parent Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Parent-Student Handbook Acknowledgement Form and Media Release