2022-2023 CCHS/CCMS Waiver/Permission Form
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Student Last Name *
Student First Name *
Which school does your student attend? *
Grade *
Online Registration
Beginning in August 2019 Clear Creek School District will be using Online Registration.  Please log into your parent portal and choose the link for Online Registration.  For directions on how to use the Online Registration Tool, please click on the following link.
Internet Connectivity
Do you have reliable Internet Connection?
Clear selection
Would an internet hot spot be helpful?
Clear selection
Walking Field Trip Permission - Immediate are near school
Today's classrooms extend beyond the physical limits of a room and teachers recognize the value of taking students on field trips.  In granting my permission for this trip I agree that my child and I will abide by the rules and procedures as provided by the sponsor for this specific field trip.
Agreement *
Release for Photograph, Interview or Videotape
I give permission for the child listed above to be interviewed, videotaped or photographed in connection with school related activities.  
Agreement *
My student may ONLY be photographed for the Yearbook
Clear selection
Do you give permission for our school health staff to screen your student for hearing and vision deficits at no charge to you?
Clear selection
If a hearing deficit is identified, do you give permission to the CCSD’s  Audiologist to perform a full hearing assessment on your student at no charge to you?
Clear selection
Do you give the School Health Team permission to assess your student's emotional and behavioral health using the BASC-3 BESS professional screening tool? These results will help us to monitor overall student health and identify those who may benefit from additional support at school.
Clear selection
Do you give permission for your student to participate in this state-wide, anonymous, behavioral and mental health survey given in the Fall of odd years?
Clear selection
Acknowledgement of Handbook
The Student Parent Handbook is  available on the school websites. It is the responsibility of the parent and student to review and understand the contents of the handbook.  My student will abide by the rules contained in the Student/Parent handbook, and I will support the enforcement of the rules contained within the said handbook.  
Parent Agreement *
Student Agreement *
Student Use of Electronic Resources Board policy File JS-E Student(Annual Acceptable Use Agreement)
I have read, understand and will abide by the district’s policy on Student Use of Electronic Resources. Should I commit any violation or in any way misuse, my access to the school district’s technology devices, including use of agree that my access privileges may be revoked, and disciplinary action and/or legal any electronic resources, I understand and action may be taken.

If I am 18 years or older, I hereby release the school district from all cost, claims, damages or losses resulting from my use of district technology devices, including use of the Internet and electronic communications, including but not limited to any user fees or charges incurred through the purchase of goods or services.

Your signature on the Acceptable Use Agreement is binding and indicates that you have read the school district’s policy on Student Use of the Networked Electronic Information Resources and understand its significance.

The policy can be found here:  https://z2.ctspublish.com/casb/browse/clearcreek-casb/clearcreek/z20000345

Agreement *
Parent Electronic Signature - Please type your first and last name *
I understand that checking this box constitutes a legal signature confirming that I acknowledge that the above information is correct *
Student Electronic Signature - Please type your first and last name *
I understand that checking this box constitutes a legal signature confirming that I acknowledge that the above information is correct *
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