Chromebook Checkout Form

Parents must complete all sections of this form and submit before a Chromebook will be checked out.
Parent Name *
Email *
Name of Student *
Grade Level *
Internet Hotspot *
Rules and Appropriate Usage
The Chromebook devices issued to students are the property of South Rock Creek Schools. Chromebooks and other school-provided devices must be used for educational purposes for which they are intended. The distribution of a Chromebook to a student may be revoked at any time for inappropriate conduct. Before a Chromebook is issued for use, students and parents/guardians will need to sign an Internet Acceptable Use Policy, Parent Permission Form and the Student User Agreement. Students are expected to abide by the following rules and behavioral expectations both at home and within the school.
Use of Equipment
School Chromebooks are to be used for research, educational and school related business only.

The use of the Chromebook must not violate the existing Internet Acceptable Use Policy that is currently in the Student Handbook.

The student may not destroy, deface, or alter the Chromebook equipment.

Students may only use the Chromebooks assigned to them. Students may not share their login or password with other students.
Engaging in online activities that are inappropriate will result in automatic termination of the student's network/internet privileges in accordance with the Student Handbook.

Sending messages via a school Chromebook with the intent to intimidate, frighten, threaten, or bully another person is considered harassment and will have significant consequences per the Student Handbook.

The South Rock Creek network has filtering in place to block inappropriate websites and content.

Chromebooks connected to the internet outside of the South Rock Creek network, such as at home or in public places, are not filtered by South Rock Creek. In these instances it is the parent/guardian's responsibility to ensure their student is using the device appropriately.
Use of Equipment *
Since the Chromebooks belong to South Rock Creek Schools, the school may monitor all devices and their usage. Improper use of South Rock Creek technology devices will result in loss of network/internet privileges and other consequences as per the Student Handbook.
Management *
By signing the Internet Acceptable Use Policy, the User Agreement and Parent Permission Form, students and parents/guardians agree to:

Accept monitoring of student usage of the Chromebooks.

Charge their Chromebook overnight each night to ensure that they are fully charged for classes the next day. Just as students are expected to be prepared for class by having all required materials, students will have a charged Chromebook available to them at the start of each day.

Protect the Chromebook from damage and theft.

If damage is intentional, willful or purposeful, the parents or guardians will pay the full replacement cost of the Chromebook and/or AC power adaptor. The price to replace a Chromebook is $275.00.

Outside of school, parents/guardians are responsible for the supervision of their student’s technology use.
Responsibilities *
Consequences for breaches of the acceptable use agreements and Parent responsibility
In the event a student breaches any part of the Internet Acceptable Use Policy or Student User Agreement, consequences will be imposed by the school, consistent with the policies in the Student Handbook. Each situation will be considered independently and consequences will range with Administration discretion. If the Chromebook is lost or purposely damaged, the student/parent/guardian will be responsible for the full replacement cost as shown below. The school regards the Chromebook as all other materials that are checked out to a student (e.g. library materials, sports, etc.)

Chromebook Replacement Cost: $275.00 (Chromebook + Power cable)
C0nsequences and Parent Responsibility *
Chromebook Internet Acceptable Use Policy and Parent Permission Slip
By electronically signing as the parent or legal guardian of the minor student named, I grant permission for my child to access networked services and school computer hardware. I have read, reviewed and understand the South Rock Creek Internet Acceptable Use Policy and the student expectations/responsibilities. I have discussed both fully with my child. I give permission for my child to use Google Apps for Education on my child's Chromebook. I understand and accept responsibility for guidance of internet use by setting and conveying the school's standards, procedures and rules when using the device. I acknowledge receipt of and hereby agree to comply with the South Rock Creek user agreement and the Internet Acceptable Use Policy contained in the South Rock Creek Student Handbook. Signatures verify the acceptance that if a device is damaged beyond use or destroyed, the parent/guardian will be responsible for payment to replace the device. Chromebook replacement cost will be $275 per unit and the Hotspot replacement will be $50 per unit. Students will not receive a new Chromebook or hotspot until the replacement cost is paid.
Parent Signature and Date
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