Community Unit School District No. 2

Community Unit School District No. 2

Consent and Permission Form 2015-2016

(Please complete one per household with OLDEST STUDENT listed first)

Student’s Full Name: Click here to enter text. Grade Level (2015-2016): Choose an item. Attendance Center: Choose an item.

Emergency Medical Treatment/Indemnity Agreement

I grant consent to Community Unit School District No. 2, its employees and agents, my child’s physician Dr. Click here to enter text.,

or any licensed or certified physician and/or medical personnel, on my behalf and in my stead, to administer emergency

medical assistance to my child as they deem appropriate. I do hereby agree to hold harmless and indemnify Community Unit ☐YES

School District No. 2, its employees and agents, either jointly or severally, from and against any and all claims, demands,

damages, or causes of action, or injuries, including reasonable attorney fees and costs in the defense thereof, resulting from ☐NO

or arising out of the provision of emergency medical treatment by school personnel or by a physician and/or by other medical

personnel.

Photograph & Press Release Consent

I grant consent to Community Unit School District No. 2 to identify a picture of my child(ren) or ward(s), by first name,

last name, and/or the school of attendance, in any District-managed material, publication, video, and/or website. ☐YES

I understand that this consent will remain valid for the entire time that my child(ren) or ward(s) are enrolled in Community

Unit School District No. 2. I understand that I may revoke this consent at any time by notifying the Building Principal.☐NO

Field Trip & Assembly Permission

I grant permission for my child(ren) or ward(s) to attend all Community Unit School District No. 2 field trips and assemblies ☐YES

during the school year. I understand that I am responsible for calling and notifying the school if I choose to NOT allow my

child(ren) or ward(s) toattend a specific field trip and/or assembly.☐NO

Textbook Loan Permission

I grant permission to Community Unit School District No. 2 to loan textbooks to my child(ren) or ward(s) in accordance with ☐YES

PA 79-961. I understand that this consent will remain valid for the entire time that my child(ren) or ward(s) are enrolled in

Community Unit School District No. 2. I understand that I may revoke this consent at any time by notifying the Building Principal.☐NO

Electronic Student Grade Access

I will access my child’s/ward’s grades electronically through TeacherEase instead of having a paper copy sent home.☐YES

☐NO

TeacherEase Access to Student Records

Community Unit School District No. 2 will once again use the web-based TeacherEase program to communicate student achievement and the Illinois E-Pay system to manage transactions (fees and food service payments). In order to fully utilize the features of these programs, you will need to establish a TeacherEase account with the District. If you already have a TeacherEase username and password, no further action is necessary. If you need access to TeacherEase, please complete the form below and the District will establish an account for you.

☐I already have a username and password for TeacherEase.

☐I need a username and password for TeacherEase and my information is as follows:

Parent/Guardian #1 Name: Click here to enter text. Email Address: Click here to enter text.

Parent/Guardian #2 Name: Click here to enter text. Email Address: Click here to enter text.

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I have read this form completely and understand its contents. I hereby certify that my responses are true and correct.

Electronic Signature: Click here to enter text. Today’s Date: Click here to enter a date.