10 million

Parent First Name/ Primer Nombre

Last Name/ Apellido

Student First Name/ Primer Nombre Estudiante

Student Last Name/ Apellido de Estudiante

Student ID/ Identificacion del Estudiante

Grade/ Grado

Name of School/ Nombre de Escuela

Student Signature/ Firma del Estudiante

Clear

Parent Signature/ Firma del Padres

Clear

Phone Number/ Numero de Telefono

Please enter a valid phone number.

Email

example@example.com

Parties shall be responsible for their own attorneys' fees and costs. Nothing herein shall be construed as

will be the sole source of my student's in

must comply with the school's and the district's Acceptable Use Polices