Student Device Loan Form
Greenwich Public Schools

Your child is being loaned a digital computing device, with necessary peripherals, for educational use only. These devices will be used to help realize the following goals:

Students will demonstrate critical thinking of online content.
Students will be self-regulators of their learning.
Students will receive quality feedback on their work.
Learning will be more personalized for students.
Students will be ready for the Smarter Balanced Assessment (SBA).

It is necessary to make clear that liability for the security and condition of the equipment rests with the borrower.

LIABILITY STATEMENT

You are strictly responsible for anything that happens to your child's borrowed Greenwich Public Schools device. You are always responsible for the safety, security, and care of this loaned device. In the event that there is any damage, destruction, or loss of this device, the District will assess your liability and responsibility to reimburse as follows:

Device Reimbursement Cost:
Apple iPad $300
Google Chromebook $330

Accessory Reimbursement Cost:
iPad Charger $12
iPad Charging Cable $12
Chromebook Charger $35

School Year Liability:
During the school year, device liability will be assessed on a case by case basis and charged to the party found responsible, if the damage was caused by negligence or recklessness, theft, or intentional conduct, subject to District discretion to replace the device.

Summer Liability:
During the summer, device liability for borrowed devices and peripherals will rest solely with you. YOU WILL BE RESPONSIBLE FOR ANY AND ALL LOSS OR DAMAGE during the summer break, except in the case of accidental damage which happens at Summer School. If you are not comfortable with this responsibility, you may opt-out and have the device stored at school over the summer. Opt-out instructions are provided towards the end of the school year.

This liability shall remain in effect as long as your child has a Greenwich Public Schools student device to use and will cease upon the return of a fully functional device that is able to be repurposed to other students.

Scope:
This form is for parents of students in grades 2-12. Pre-K, Kindergarten, and 1st Grade parents do not need to fill out this form.

Student's First Name *
Your answer
Student's Last Name *
Your answer
Student's ID Number
Your answer
Student's School *
Student's Grade *
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Parent's Email Address *
Your answer
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