EAST LYME PUBLIC SCHOOLS: 2017-2018 STUDENT PERMISSION FORM

Movies

My child has permission to watch G rated movies at school.(Elementary & up) ☐Yes ☐No
My child has permission to watch PG rated movies at school. (Elementary & up) ☐Yes ☐No
My child has permission to watch PG-13 rated movies at school. (Middle School & Up) ☐Yes ☐No
My child has permission to watch R rated movies at school. (High School & Up) ☐Yes ☐No

STUDENT YEARBOOK

May we include your child’s picture and name in the yearbook? ☐Yes ☐No

PERMISSION FOR PUBLICATION

On occasion during the current school year, there may be opportunities to display samples of student work, publicize the names of students, to videotape, or to take pictures of students who are participating in a program or classroom that attracts the interest of an educational publication or the media. We must have permission from parents to publicize this information.

East Lyme School System has my permission to

Display samples of my child’s work. ☐Yes ☐No
Publicize my child’s name. ☐Yes ☐No
Videotape my child. ☐Yes ☐No
Take pictures of my child for use in an educational publication or in the news without my prior approval. ☐Yes ☐No

Public Performance on World Wide Web

I give permission for East Lyme Public Schools to post videos on East Lyme districtwebsite. ☐Yes ☐No
(including but not limited to: classroom lessons, concerts, sporting events, assemblies, and plays)
I give permission for East Lyme Public Schools to post videos of my child on East Lyme Livestreaming channel. ☐Yes ☐No
(including but not limited to: classroom lessons, concerts, sporting events, assemblies, and plays)
I give permission for East Lyme to post photographs of my child on the East Lyme District website. ☐Yes ☐No

FIELD TRIPS

During the school year, teachers plan study trips as part of the curriculum and instructional program. We must have permission for students to participate in these programs.

My child has permission to participate in school field trips during the current school year. ☐Yes ☐No
I understand that the school will notify me prior to the scheduled trip.

My East Lyme Middle School Child has Permission to:

☐Walk Home ☐Ride Bike Home ☐Walk to East Lyme Public Library ☐Walk to Youth Center

STUDENT/PARENT HANDBOOK

I have reviewed and understand the policies, procedures and expectations outlined in the student/parent handbook posted on the East Lyme Public School’s Website at (Tab-Parents & Students) (Tab-Parent & Student Information) (School Handbook-Choose correct school)
Student’s Signature: ______Date: ______
Parent’s Signature: ______Date: ______
Sophomore, Junior and Senior Parents Only (No Child Left Behind Act of 2001 – Section 9528
As you may know, the Congress of the United States of America passed in December of 2001 legislation which requires the East Lyme Public Schools to provide certain information to military recruiters after July 1, 2002. The information that the school district is obliged to provide military recruiters is limited to the name, address and telephone numbers of grade
11 and 12 students in the East Lyme Public Schools. This notification is also given to grade10 parents because the information will be provided to military recruiters, unless noted below,prior to the start of their child's junior year.
The school district has an obligation to notify you of the existence of this legislation.It further has the obligation to advise you that if you wish to prevent the disclosure of your child's name, address and telephone number to military recruiters, you must notify the school district of your intention to deny the disclosure of your child's name, address and telephone number to military recruiters by the school district.
*Parent signature only if you deny the disclosure of your child's name, address and telephone number to military recruiters by the school district.
Parent’s Signature: ______Date: ______