Letcher County Schools Parent Signature Forms
Parents and Guardians,
Sign below stating that you understand that a link to the Code of Conduct Book is on the Letcher County
School Homepage and that a printed copy is available upon request. If you do not want your child’s picture to
be used on the Letcher County Schools web page or in the newspaper, sign the Photo Form. If you want to give
your permission for your student to use ‘ILP’ software, please the permission form below. If you want to give
your permission for your child to use the internet at school, please sign the Student User Access Contract on the
other side of this page!!
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CODE OF CONDUCT BOOK IS ACCESSIBLE AT www.letcher .kyschools.us
I AM AWARE THAT A COPY OF THE LETCHER COUNTY SCHOOLS 2014-2015 CODE OF CONDUCT BOOK CAN BE VIEWED ON
THE LETCHER COUNTY SCHOOLS HOMEPAGE AND A PRINTED COPY IS AVAILABLE UPON REQUEST.
__________________________________
NAME OF STUDENT
_____________________________________ ________________
SIGNATURE OF PARENT / GUARDIAN
DATE
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DO NOT SIGN THIS SECTION IF YOU WANT TO ALLOW THE SCHOOL SYSTEM TO USE YOUR CHILD’S PHOTO
During the school year we often take photographs or make videotapes of children in the classroom for classroom use,
professional staff training, newspaper publication and recognition of special accomplishments of the student and / or
school. The school also likes to release information to the media concerning students at our schools. The information
released concerns students academic accomplishments, awards received and other accomplishments. The school might
release student grades, parent / guardian names, address, age and school attended. The school will assume that it has
guardian permission to release the above mentioned photos and records to the media unless the parent or guardian
objects. If you object, please sign below stating that you do not give permission.
I do not give permission for _______________________________ (my child) to be photographed or videotaped and I
do not want awards or other accomplishments to be released to the media.
_________________________________________________
Signature of Parent/ Guardian not giving permission
______________________________
Date
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Individual Learning Plan Web Release
I am the parent or guardian of ________________________________________, a student under the age of eighteen
(18) who is enrolled in grades 9-12 in the Letcher County School District. I hereby authorize the District to enable a
feature of web based Individual Learning Plan (‘ILP’) software, which will permit my student to invite third parties to
have access to his/her ILP information or portions of such information via the web (internet). The purpose of this
feature is to help my student with career and college plans by permitting him/her to share ILP information with persons
or organizations such as college admissions officers, organizations offering scholarships, and potential employers.
However, I understand this feature could permit my student to release ILP information to other third parties. I agree
that the District, its employees, and agents shall not be responsible, nor shall they incur any liability for any disclosure
made by the student using this software feature. The Family Educational Rights and Privacy Act (FERPA) and similar
state statutes (KFERPA) generally require parents to consent before the educational records relating to their student(s)
are disclosed to third parties.
I understand that the above software feature is not itself a disclosure of education records, but it will enable my student
to disclose confidential educational records information. I specifically authorize and give my consent to the disclosure
of ILP educational records information to third parties by my student through the use of the software feature as
described above.
I understand that once this signed form is returned to the school, it will stay in effect as long as my child is enrolled in
the District (unless I or my child on turning 18 requests a change).
I also understand that the sharing feature will not be enabled for my child unless this completed form is returned to the
school.
_______________________________________________
___________________________
Signature of Parent / Guardian
Date