Device Parental Consent Form - Device
I am receiving from the School District of Manatee County (“District”) a computer/device identified
below (“Equipment”) that my child can use outside of the school campus for educational purposes. The
Equipment is and will remain the property of the District. Any additional property provided to support the
use of the “device” should be returned to the District in good working order (i.e., power adapter). I agree
to return the Equipment to the school when requested by school administration or on the last day my
student is enrolled in his/her school.
I understand that the Equipment, like textbooks, workbooks, and library books are instructional materials,
and that I am legally responsible for the replacement cost of the Equipment if it is lost, stolen, damaged or
seized while in my possession. I am responsible to ensure that the Equipment is cared for properly. If the
Equipment is stolen while in my care, I understand that I am responsible to file a police report with the
appropriate agency, report the item missing or stolen to school, and provide the school a copy of the
police report within five school days.
I understand that the Equipment has the capability to connect to the INTERNET. While the District
makes every effort to limit access to inappropriate content through INTERNET filtering systems, it is the
responsibility of the parent/guardian to monitor and control the student's use of the Equipment outside of
the school campus. Inappropriate use is a violation of the Code of Conduct for Students and School Board
Policy 7540.03 – Student Technology Acceptable Use and Safety.
The District reserves the right to monitor or access the contents of its computers if it suspects or is
advised of possible breaches of security, harassment, or other violations of policies, rules, regulations,
directives, law, or evidence exists which demonstrates to the school or District that its computers may
contain information, data, or other intellectual property that belongs to another person. Students have no
expectation of privacy of content stored on or accessed through District Equipment.
Any software and instructional content contained on the Equipment is licensed to the District. Any
copying, modification, merging or distribution of the software is prohibited. The student is responsible for
complying with any and all hardware, software and service provider licensing agreements, terms of use
and applicable state and federal copyright and other intellectual property protections. Violation of any
such licenses, terms or laws shall constitute a violation School Board Policy 7540.03 - Student
Technology Acceptable Use and Safety.
Students must not intentionally modify system configuration files, hardware
(device) or otherwise interfere with the functioning of the Equipment. Only software/applications
approved by the District may be installed on the Equipment. Authorized District Information Technology
Division personnel only are permitted to repair equipment.
Device Parental Consent Form - Device
I have read and understand the information on this form. By signing this form, the
parent/guardian agrees to assume all responsibility for the equipment signed out to the student.
A replacement fee listed below will be charged if the device is lost, damaged, or not returned.
Replacement costs:
Power Adapter & Cable: $10.00
give my child permission to sign out a computer/device as often as needed through the current
school year:
Student’s Name and Student ID (Please Print Clearly):
Parent/Guardian’s Name (Please Print Clearly):
Parent/Guardian’s Signature:
Parent/Guardian’s Phone Number and/or Email Address:
Date: _______________________________
Device Serial Number: _____________________
The district is required to maintain Children's Internet Protection Act (CIPA) compliance while
these devices are connected to the INTERNET. The protection measures must block or filter
Internet access to pictures that are: (a) obscene; (b) child pornography; or (c) harmful to minors.
click to sign
click to edit