Student Name (Please Print) ________________________ Grade____________

Riverdale School District

Your child has requested access to the Riverdale computer network. This access includes connections to computers through the Internet, which would connect your child with educational resources all over the world.

Please read Riverdale's Use Policy with your child. In accepting an account, your child accepts the responsibility of using the network in an appropriate manner. It is important that you understand his/her responsibilities as well. Your signature indicating that you have read and agreed to our Use Policy is necessary before an account will be issued.

I have read the Student Use Policy for Network Access at Riverdale School and agree to use the school network in an appropriate manner.

_______________________ _________ student signature/ date

I have read the Student Use Policy for Network Access at Riverdale School and give the school permission to issue an account to my child.

_______________________ _________ parent signature/ date

Riverdale School District #51JT 11733 SW Breyman Ave. Portland, OR 97219