Chromebook Usage Agreement Form 2021-2022
Email *
Full name of Parent/Guardian completing this form (First Name Last Name): *
This form is required for all students at Cherry Creek Academy. Please note: "No" or "Disagree" responses will result in your student being unable to utilize technology at Cherry Creek Academy.
Student(s) First Name, multiple students separate by a comma and in order of younger grade to older grade: *
Student(s) Last Name: *
Student Grade (from youngest to oldest):
Student 1 (youngest student)
Student 2
Student 3
Student 4
Student 5
Clear selection
I have read and understand the Cherry Creek Academy Chromebook Handbook. *
I understand that my student will not be assigned a Chromebook (incoming 1st graders who've already been assigned will lose access) unless I complete the summer Cherry Creek School District Parent Forms, specifically accepting the CCSD "Internet and Network Resources Acceptable Use Waiver". For a screen shot of the wording, please see it in the Cherry Creek Academy Chromebook Handbook here: *
I have read and understand the "Chromebook Assignment and Student Responsibilities" within the Chromebook Handbook. *
I have read and understand the "Student Responsibilities and Chromebook Care" section written within the Chromebook Handbook. *
I have read and understand the "Chromebook Repair" section within the Chromebook Handbook and I understand we are financially responsible for any damage to the Chromebook assigned to my student(s). *
I understand the Chromebook must be returned prior to or during Chromebook Check-in at the end of the school year. The device must be received in good working order, with no added stickers or physical damage. The charger must be returned in good physical working order. Grades K-4 must return the chromebook cases. All devices / chargers will be thoroughly inspected during the summer and any notice of damage will be sent home before the start of school August 2020. Students are responsible for damage found during this time. *
By checking the box "Agree", I acknowledge that I am the parent or legal guardian of the above named minor and I grant permission for this student to access networked computer services and school computer hardware. I have read and understand the school and district guidelines concerning the use of school computer networks and agree to abide by them. I further understand that any violation of these or other district or school rules is unethical and may constitute a violation of law. Should I commit any violation, I may be responsible for payment for damages and repairs and may face disciplinary action including, but not limited to, loss of access privileges, suspension, expulsion or dismissal. I also understand that legal action may be pursued. *
By checking the box "Agree", as the parent/guardian of this student, I have read the school and district’s guidelines concerning the use of district computer networks including the Internet. I understand that access is designed for educational purposes. However, I also recognize it is impossible for the school and district to restrict access to all controversial materials and I will not hold the school, district, or its employees or agents responsible for materials acquired on the Internet. I also understand that I am financially responsible for materials acquired on the Internet. I also understand that I am financially responsible for my child’s actions should those actions result in damage to school resources. I hereby give permission for my child to use the networked computer system which includes filtered Internet access. *
A copy of your responses will be emailed to the address you provided.
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