Clark County School District
ANNUAL RELEASE AND NETWORK ACCESS FORM
Student Name / Nombre del estudiante
First Name
Last Name
Student ID Number / numero de identificacion estudiante
School / Escuela
Grade / Grado
Please Select
9
10
11
12
School Year / ano escolar
I give permission to release information described above about my student for use in CCSD OWNED/PRODUCED materials. Examples include school newsletters posted on CCSD.net that contain student photographs and school district PowerPoint or video presentations that include personally identifiable student information.
3. COMPUTER NETWORK ACCESS:
I give permission for my student to access, produce, video conference, and communication information on the District computer network resources in accordance with the Acceptable Use Policy of the Clark County School District. Student work, artwork, or projects will be identified by first name, grade, and school only. Students who do not have parent/guardian permission to use the District's computer network will be given alternative educational activities.
Printed Name of Parent/Guardian / Nombre impreso del padre
Signature of Parent/Guardian / Firma del padre
Clear
Student Signature / Firma del estudiante
Clear
Date / Fecha
-
Month
-
Day
Year
Date
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Should be Empty: