Parent/Guardian Student Issued Device Agreement and Release

Student First Name *

Student Last Name *

Student Grade *

Student School *

South Lake High School South Lake Middle School Elmwood Elementary Avalon Elementary

Parent Email: *

example@example.com

If your child did not have access to a device from South Lake Schools, would they have access to an appropriate device to complete school work outside of school?

Yes No

I/We have read and understand the terms of the Procedures and Rules for the Acceptable Use of the Student Issued Device (hereinafter called the “Device”) and the Student Issued Device Agreement and have discussed them with my/our child.
I/We have read and understand the terms of the Parent Student Issued Device Agreement and Release.
I/We give permission to the School District to open a managed Apple ID and Office 365 user account for my/our child.
I/We consent to and understand that School District staff may monitor my/our child’s electronic communications, including e-mail and files that he/she downloads, as well as consent to allow my/our child to use the Device and related accounts and I/we assume the risks associated with my/our child’s use of the Device and related accounts.
I/We have discussed the South Lake Schools Student Issued Device Agreement with my child and will support the School District in guiding my child in using the Device outside of school as an educational tool.
I/We understand that I am responsible for monitoring and guiding my child’s activity outside of the school day to ensure appropriate access to the Internet and use of the Device.
I/We understand that I, and or my student are financially responsible for damage to or the loss of the Device, as well as for any costs incurred due to my student’s use of the Device or related accounts.
I/We understand that South Lake Schools will provide insurance for my child’s device for $20 per device. The insurance will cover the device for damage or loss one time, the case, and all accessories. if I/We decide against purchasing insurance coverage for the device I/We will be responsible for any damage/theft of the device and accessories as described below.

Device Fees for accidental damage:

1st incident – parent pays cost of repair up to $250
2nd incident – parent pays full replacement cost of device (~$430)
Device fee for theft: (police report required within 7 days):
Parent pays full replacement cost of device (~$430) plus cost of missing accessories

Device Fee for Malicious Damage:

Parent pays full replacement cost of device (~$430) plus cost of damaged/missing accessories

Miscellaneous Part Damage (charger, case, etc.):

Case/Keyboard - $99
Charger - $15
Charging Cable - $8

Date *

Date

I/We hereby agree torelease, indemnify and hold harmless, in both my/our personal capacity, and asguardian of my/our child, the School District as well as its board members,school teachers, employees administrators, and adult volunteers, from any claimsarising out of my/our child’s violation of, or conduct inconsistent with, theSchool District’s Acceptable Use Procedures and Rules and the Student IssuedDevice Agreement, including, but not limited to, claims arising from materialsmy/our child may download or relationships he/she may establish with peopleonline, whether such claims arise from Internet use through school accounts orpersonal accounts. *

Yes No

Parent Name *

Digital Signature

Clear