James T. Perry Administration Center ● 1525 West Frye Road ● Chandler, AZ 85224
(480) 812-7000 ● FAX: (480) 224-9128
"Dedicated to Excellence
Camille Casteel, Ed.D., Superintendent
Virtual Learning Consent Form
I hereby consent to the Chandler Unified School District’s collection, use, and/or disclosure of information
about my child through the course registration process and other manual and/or electronic procedures of CUSD
or associated course providers. I understand that my child is registering for a virtual course or participating in
virtual learning, and that the information collected is needed for both course registration and progress reporting
to my child’s school and to CUSD.
This consent form covers all forms of distance learning courses, including but not limited to satellite courses,
video courses, and web-based courses. Your child’s image may be transmitted during video portions of distance
learning and online courses.
Student Name: ____________________________________________________________
I grant permission for my child to participate in live virtual learning. I understand that live virtual learning is not pre-
recorded and that anything stated or exposed during the virtual learning session can’t be edited before the student
witnesses the content.
Guardian Signature:__________________________________________ Date:____________
Electronical Consent
I verify that the student’s parent or legal guardian has submitted digital consent (email) after reading this virtual learning
Verified by:________________________________ Guardian: ______________________________
Telephone Consent
I verify that I have spoken to the student’s parent or legal guardian by telephone, and obtained his or her permission after
reading this virtual learning document.
Verified by:________________________________ Guardian: ______________________________
CUSD has taken this steps in order to be in compliance with federal legislation for child protection, including The Family Educational
Rights and Privacy Act (FERPA - and the Children’s Online Privacy Protection
Act (COPPA -
All students using computers from school locations must agree to abide by school, county, and/or CUSD Policy 2460 (Safety and Acceptable Use of
the Internet by Students and Educators). It may be viewed online at
, or you may request a copy from your child’s
school. It is the intention of the Chandler Unified School District to filter and restrict access to controversial materials from school computers.
However, since the online courses are web-based, content accessed from home or elsewhere outside the school could put the student in contact with
objectionable materials via the World Wide Web. It is the responsibility of the parent/guardian of the student to restrict any access to materials
deemed inappropriate by the parent/guardian.