*School Policy Checklist

School Policy Checklist
Listed below are some of the policy/procedure items for which the school requires a parent’s signature or permission. These are available for review on our school website: www.stmarysbreck.com under the admissions tab (admission forms) at the top. Please check off items and sign at the bottom if you understand the policy/procedure.
Please check off items and sign at the bottom if you understand the policy/procedure.

Internet / Technology Acceptable Use Agreement – A check indicates you and your child(ren) have reviewed the agreement, read the “Technology” section in the handbook, and that you grant permission for supervised use of electronic devices/access to the internet. If you would like a copy of the agreement they are available in the office. Guidelines will also be reviewed with students at the start of the school year.Photo Use - I give permission for my child’s photo to be used in the yearbook, on social media, by local media, and on the school website.Video Use - I give permission for my child’s work/performances (talent show, Christmas program, etc.)to be used on social media, on the school website, or on television.In-Town Field Trips – I give my child permission to attend school sponsored events within the citylimits of Breckenridge and Wahpeton. I understand that the travel may involve walking or riding in avehicle. You will be notified in advance when your child will participate. Out of Twin Town area tripswill require a separate permission slip.Attendance Visitor Badge Procedure: All parents must come into the office and sign their child(ren)into or out of the building when arriving late or leaving early. All adults require a visitor badge when entering the school.Parent/Student Handbook: I have reviewed the handbook and agree to follow the information in it.o If you would like a hard copy you can pick one up in the school officeType option 6Yes: I understand the policies/procedures that I have checked above.
Child (ren) Name (s)
Child (ren) s Signature (s) - ( May also sign after discussion at school.)

Powered by Jotform SignClear
Parent/ Guardian (Printed Name)
Parent/ GuardianSignature

Powered by Jotform SignClear
Date

MonthDayYear
Date
Should be Empty: