Chimcaum School District
Informed Consent Agreement
for use of the Internet


 

I, , now understand the expectations for

              (Student's Name)

school use of the Internet and agree to follow the guidelines written above. I participated in an Internet instructional lesson with

on .

             (Staff Member's Name)                                          (Date)

I agree to give up my Internet privileges if I don't follow the rules stated in this agreement.

Consequences:

  1. Loss of privilege - short term, long term, or permanently.
  2. Written student plan with parent and principal signature.

Student Signature

Date


Parent Signature

Date


Teacher Signature

Date

A new agreement must be signed by each user of Internet at the beginning of each school year and kept on file.