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Millersburg Area School District (MASD)
Pledge for Student Device Use & Insurance Form
- I will use and care for my Device responsibly as described in the Acceptable Use Policy while at school and at home.
- I understand that a District Device is subject to inspection at any time without notice and remains the property of the Millersburg Area School District.
- I will never leave the Device unsecured or unattended, and I am responsible for knowing the location of my Device at all times.
- I will not use stickers, markers, etc., on a District Device or do anything to permanently alter the Device.
- I will password protect my Device and never loan out my Device or give my password to other individuals.
- I will not let anyone else use my Device other than my teachers, administrators, or parents/guardians.
- I will charge my Device’s battery daily and arrive at school with my device charged.
- I will keep food and beverages away from my Device since they may cause damage to the device.
- I will clean the Device’s screen with a soft, anti-static cloth only, using no cleaners.
- I will not disassemble any part of my District Device or attempt any repairs.
- I will not remove or deface the serial number or other identification on any District Device.
- I will cooperate in the filing of a police report in case of theft, vandalism, or other acts covered by insurance and inform my building administrators.
- I will be responsible for all damage to, or loss of the Device, caused by neglect or abuse.
- I agree to return the District Device and power cords in good working condition.
Select One
____ Device Insurance: $25.00 - Checks payable to <NAME>
____ Opt Out - I have reviewed the stated Pledge for Device Use and Acceptable Use Policy and choose to opt OUT of the District’s insurance. Since insurance is not being purchased, I understand that I will be financially liable for the full replacement or repair cost as determined by the Technology Department and building principal.
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Date Signature of Student Printed Name of Student
____________ ________________________________ ______________________________________
Date Signature of Parent/Guardian Printed Name of Parent/Guardian