CIPA (Children’s Internet Protection Act) CIPA 20-21 School YearEmail* Enter Email Confirm Email Email address of the person filling out the form (so we can respond to you if necessary)Form InformationStudent Name*Student Signature*As the parent or guardian of the student signing above, I have read the Internet Acceptable Use Policy (ISP) and guidelines for independent use established by ERLACS. I grant permission for my son or daughter to access networked computer services such as electronic mail, the Internet, and World Wide Web. I understand and agree that individuals and families may be held liable for violations. I understand that some materials on the computers or Internet may be objectionable, but I accept responsibility for guidance of computer or Internet and World Wide Web use – setting and conveying standards for my son or daughter to follow when selecting, sharing, or exploring information or media. Furthermore, I accept full responsibility for supervision if and when my child’s use is not in a school setting.Parent or Guardian Name*Parent or Guardian Signature*PhoneThis field is for validation purposes and should be left unchanged.