Internet Use -Permission Form

Please review the attached school Internet Acceptable Use Policy, sign and return this permission form to the Principal.

Name of Pupil:          ____________________________

Class / Year:              ____________________________

Pupil
I agree to follow the school’s Acceptable Use Policy on the use of the Internet. I will use the Internet in a responsible way and obey all the rules explained to me by the school.

Pupil’s signature:      ____________________________

Parent/Guardian
As the parent or legal guardian of the above pupil, I have read the Acceptable Use Policy and grant permission for my son or daughter or the child in my care to access the Internet. I understand that Internet access is intended for educational purposes. I also understand that every reasonable precaution has been taken by the school to provide for online safety but the school cannot be held responsible if pupils access unsuitable websites.

I accept the above paragraph |_|                  I do not accept the above paragraph |_|
(Please tick as appropriate)

Signature:   ______________________    Date:           ______________________

Address:     ______________________   Telephone:           ______________________

            ______________________

            ______________________

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