Authorization Forms: 2020-2021
Below are several school policies that require parent authorization. Please review the policies and mark your compliance by checking YES for each policy. If you have any questions, please contact Superintendent Chad Jones or Assistant Principal Alisha Schoedel. One form should be completed for every child at Hollis.
Student Name (first & last): *
Student Grade: *
Internet Access Authorization/Acceptable Use Policy: Students must have a parent/guardian read and agree to the following before being granted unsupervised access: All use of the Internet shall be consistent with the District’s goal of promoting educational excellence by facilitating resource sharing, innovation, and communication. The failure of any user to follow the terms of the Acceptable Use Policy will result in the loss of privileges, disciplinary action, and/or appropriate legal action. The signatures at the end of this document are legally binding and indicate the parties who signed have read the terms and conditions carefully and understand their significance. I have read this Authorization form. 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 children's use is not in a school setting. I have discussed the Acceptable Use of Electronic Networks with my child. I hereby request that my child be allowed access to the District’s electronic network, including the internet. Students:I understand and will abide by the above authorization for electronic network access. I understand that the District and/or its agents may access and monitor my use of the internet, including my email and downloaded materials, without prior notice to me. I further understand that should I commit any violation, my access privileges may be revoked, and school disciplinary action and/or legal action may be taken. In consideration for using the District’s electronic network connection and having access to public networks, I hereby release the school district and its board members, employees, and agents from any claims and damage arising from my use of, or inability to use the District’s electronic network, including the internet. *
Receipt of Handbook: I acknowledge receiving electronic access to the Student/Parent Handbook and School Board policy on student behavior. I have read these materials and understand all rules, responsibilities, and expectations. I understand that the Student/Parent Handbook and the School District policies may be amended during the year and that such changes are available on the School District website or in the school office. I understand that my failure to acknowledge this receipt and understanding will not relieve my child or me from being responsible for knowing or complying with school rules, policies, and procedures. The 2020-21 Handbook can be found on the school website at . You may also request a paper copy by provided to you. Please contact the office for this request. *
Photo Authorization: During the year, photographs and/or videos will be taken of students participating in lessons, class projects, field trips, and events. These photos are used on our website,, on various social media platforms, and for students who have chosen a remote learning option. I grant permission for my child’s name/picture to be used in district publications. *
Field Trip Permission: I give permission for my child to attend all regularly scheduled classroom field trips for the school year. I understand that Hollis Grade School District 328 is not responsible for any accidents during these trips. Each teacher will notify me of the individual type of trip scheduled, the date and time away from school, and the specific place to be visited. I will also be informed of any other details, if any. When notified of the specific trip, I may object to my child participating at that time. *
Parent/Guardian: Please type your name (first and last) into the spaces below. This will serve as your signature. *
Student: Please type your name (first and last) into the spaces below. This will serve as your signature. *
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