Form jcda-3 One Team, One Goal: Student Success

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Form JCDA-3

One Team, One Goal: Student Success


2016-2017 School Year

Student Name








I have received the Family Information Guide (Guide), which includes the Student Codes of Conduct and the student Interscholastic/Extracurricular Code of Conduct, and understand that I am responsible for reading and understanding this information. Parents/guardians are responsible for ensuring their students understand this information.

I understand that this Guide contains rules that students are expected to follow at school, on school grounds; off school grounds at a school activity, function or event; going to and from school by bus or other transportation provided by the District; at school bus stops; while in any vehicle used in connection with a school function or activity; or while using the school technology resources.
I understand that students and parents/guardians are responsible for ensuring that use of school technology resources, including the Internet, is in compliance with Administrative Rule IFBG-R (Technology Acceptable Use), and the appropriate Student Code of Conduct, Administrative Rule JCDA-R. A parent/guardian who has concerns regarding his/her student’s use of technology, including access to the Internet, should contact the Principal or designee.
I also understand that this Guide contains information about possible legal consequences if a student does not attend school as required by Georgia law in Section 20-2-690.1. If a child has more than five (5) unexcused absences, parents, guardians, or other persons who have control or charge of a child are subject to fines, imprisonment, community service or any combination of these penalties. Absences may also affect a student’s ability to maintain or obtain a driver’s license and to park on school property. Absences that are excused are defined by the Georgia Board of Education and are listed in Administrative Rule JB-R (Student Attendance) and may be accessed at
I hereby consent to receive autodialed and/or pre-recorded communications from or on behalf of the Cobb County School District and/or my student’s school at the telephone number(s) that my family has provided to the District and/or school, including wireless number(s), if applicable. I understand that I may opt out of receiving these communications at any time by notifying the District as described in this Guide.
If I have any questions about information contained in the Guide, I will ask a school administrator to discuss those questions with me. Failure to sign and return this form does not relieve me from complying with and understanding the information enclosed in the Guide.
Parent/Guardian Signature: Date:
Student Signature: Date:
Information regarding student clubs and organizations will be available in student handbooks, school-provided information and/or on school Websites.
I decline permission for my child (under the age of 18) to participate in the following school club(s) which are defined as curriculum related student groups and all faculty-led non-curriculum related student groups which do not hold or espouse any particular religious, political, or philosophical beliefs:

I understand that I should discuss this prohibition with my student. I also understand that Administrative Rule JHC-R (School Clubs/Organizations and Student Organizations) provides more information regarding school clubs.

Parent/Guardian Signature: Date:

7/1/16: Student Support *JCDA-3* Page of

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