Form Ccf-588 - Annual Release And Network Access Form - Clark County School District Page 2
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2Clark County School District
ANNUAL RELEASE AND NETWORK ACCESS FORM INSTRUCTION ShEET
Please read the following carefully before signing the attached document. You will be expected to abide by the policies described
herein. The parent/guardian must complete all three sections on the attached Annual Release and Network Access Form:
(1) Restrict Release of Directory Information; (2) Media Release; and (3) Computer Network Access.
Once signed and dated, the attached form shall remain in effect until the end of the current school year. At any time during the school
year, however, you may revoke this permission for future use by notifying, in writing, the principal of your student’s school.
1. RESTRICT RELEASE OF DIRECTORY INFORMATION (to be completed by parent/guardian only)
The Clark County School District releases Directory Information to qualified agencies upon request. Qualified agencies include, but are
not limited to, public colleges and universities, Nevada State Treasurer’s Office, and the military branches. Release to military branches
is mandated by federal legislation – NO CHILD LEFT BEHIND Act. Directory Information is information not generally considered harmful
or an invasion of privacy if disclosed. See District Regulation 5125.1.
The term “Directory Information” means one or more of the following:
1. Student name
2. Date and place of birth
3. Address
4. School attended
5. Grade level
6. Photographs (only when used in printed school publications as defined in 5125.1)
7. Participation in officially recognized activities and sports
8. Weight and height of members of athletic teams
9. Degrees and awards received
Parents have the right to have Directory Information restricted upon request. Please indicate your directions to the District regarding
the release of your student’s Directory Information, by checking the appropriate box on the attached form.
2. MEDIA RELEASE (to be completed by parent/guardian only)
At times during and after the school day, school personnel, contracted vendors, and/or news media may ask to interview, photograph,
audiotape, film and/or videotape students. The material that may be utilized in media includes, but is not limited to, the following:
newspaper articles, television coverage, websites (including CCSD.net), internal or external publications, newsletters (including
school newsletters, other than Directory Information in school newsletters which is covered in #1 above), video presentations,
and/or school district presentations. The material may be reduced to either print or electronic format, and may be utilized in either
internal or external media sources.
If you choose to allow releases, your signature on the attached form authorizes the school and/or school district to release your
student’s name, photograph, and/or audio/video/film production for publication related to school functions and activities. Examples
may include, but are not limited to, student activities, individual or group achievements, sporting events, musical or theatrical
presentations, and/or discussion forums.
3. COMPUTER NETWORK ACCESS
Parent Agreement:
Please read the terms and conditions for the Clark County School District’s Acceptable Use Policy. Access to the Clark County School
District’s educational network resources is designed for educational purposes, and the District has taken precautions to eliminate
access to controversial material. However, please recognize it is impossible for the District to restrict access to all controversial
materials. Furthermore, if your student does not follow the Clark County School District’s Acceptable Use Policy, privileges to access
the District computer network resources may be revoked.
Student Agreement:
Students must also indicate that they understand and will abide by the Acceptable Use Policy of the Clark County School District.
Furthermore, they must understand that violating the Acceptable Use Policy may result in loss of network privileges and/or other
district disciplinary measures.
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