RRCA Chromebook Agreement Form 2017-18
The purpose of this form is to ensure that students and parents have fully read and understand the RRCA Chromebook Policy. Parents and students will acknowledge they have read the policy completely at the bottom of this form.
Email address *
Student Last Name *
Your answer
Student First Name *
Your answer
Student / Parent Responsiblity

Each student will be responsible for the device that has been assigned to them.

Each parent will be responsible for purchasing the full coverage Chromebook insurance annually ($30) and purchase a Chromebook case from the school ($15 one-time fee) before their Chromebook will be assigned.

Insurance – Full Coverage with $0 deductible. The unlimited Incidents coverage includes:

• Accidental Damage (drops/cracked screens and liquid spills)
• Liquid submersion
• Theft (requires a police report)
• Fire/Flood Damage
• Vandalism (requires a police report)
• Natural Disasters
• Power Surges due to lightning

In the event that the device is permanently lost (not returned or missing, etc.) or intentionally damaged, the student/parent will be responsible to pay the $300 fee for the replacement of the Chromebook plus a $26 re-licensing fee to be able to connect to the school’s google network.

In the event that the power cord is damaged or the case is broken, the student/parent will be responsible for paying an appropriate replacement fee.

If the Chromebook is damaged and/or inoperable, the student will be responsible for returning the device to the school for repairs. During the school year, a loaner Chromebook will be issued for the duration of the repair.

Acknowledgement of Responsibility
I acknowledge that I am responsible for the Chromebook and power cord that has been issued to me/my student. I acknowledge that use of a Chromebook is subject to the RRCA Chromebook Policy, Acceptable Use Policy, the Parent/Student Handbook and the Code of Conduct. If the unit is lost or damaged, I understand that I will be charged for the replacement as outlined above.
I have read and reviewed the RRCA Chromebook Policy and agree to its terms and conditions (Initial here.) *
Your answer
I understand that I need to bring $45 (for insurance and protective case) in cash or check to Crusader Orientation or the beginning of school to receive my Chromebook (Initial here.) (Returning students pay only $30 for insurance and already have their case). *
Your answer
If the device is lost, not returned, or intentionally damaged, the student/parent will be responsible to pay the $300 fee for the replacement of the Chromebook plus a $26 re-licensing fee (initials here). *
Your answer
Type in Student name *
Your answer
Type in Parent name *
Your answer
Date of Student and Parent Signature *
Agreement *
A copy of your responses will be emailed to the address you provided.
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