Rooks Creek CCD #425
PARENTAL CONSENT FORM
Child’s Name ______Grade ______
Announcements of school closings will be made over WJBC, WTRX, WBWN, WBNQ, WEEK TV 25, HOI 19 radio and TV stations, and the school website (www.rookscreek.k12.il.us). It is extremely important that you make arrangements in advance so that your child knows where he/she is to go.
1. My child should first go to (if home, write HOME on the blank below):
______
Name Address Phone
2. Other—please explain:
______
PLEASE INITIAL THE APPROPRIATE SPACE BELOW FOR THE FOLLOWING ITEMS:
1. If I cannot be reached when my child becomes ill or injured at school and needs emergency care, I authorize responsible school authorities to send my child, properly accompanied, to an available hospital or physician. I understand I assume all responsibility and expenses including transportation incurred by emergency care.
______Yes ______No
2. I have received the Graymont Grade School Handbook that explains school policies.
______Yes ______No
3 From time to time throughout the school year, classes will have the opportunity of taking field trips. Notification of these trips will be made prior to the trip. I give my permission for my child to go on field trips with his/her class.
______Yes ______No
4. I have read the Authorization for Internet Access. I understand that access is designed for educational purposes and that the District has taken precautions to eliminate controversial material. However, I also recognize it is impossible for the District to restrict access to all controversial and inappropriate materials. I will hold harmless the District, its employees, agents, or Board members, for any harm caused by materials or software obtained via the network. I accept full responsibility for supervision if and when my child’s use is not in a school setting. I have discussed the terms of this Authorization with my child. I hereby request that my child be allowed access to the District’s internet.
______Yes ______No
6. I give my permission for my child to be photographed and have his/her name accompany photographs for newsletters and newspaper articles that are published in recognition of individual or class/team awards and accomplishments at Graymont Grade School.
______Yes ______No
______
Parent Signature Date