ROCKY TOP MIDDLE SCHOOL

Computer/Internet Device Custody and Use Agreement

Please complete and return before equipment will be issued.

District-owned equipment that is removed from school is subject to

Superintendent Policy 3800. Use of the equipment must comply with
Superintendent Policy, including without limitation Policy 5035, Student Use of
Computers, the Internet and Electronic Communications. By signing below, you agree that:

You are personally responsible for the equipment listed above. If the equipment is damaged, lost or stolen, you are
responsible for the reasonable cost of repair or replacement, as determined by the District, on the date of damage or loss.
Damage, loss or theft of the equipment must be reported to the District on the next school day following the occurrence.

The District may remotely monitor, update and disable equipment to protect the Districts network, systems, the device
and/or data on the device.

Legal title to the equipment will at all times remain with the District.

The District may revoke this agreement at any time for any reason. Upon notice of revocation of the agreement, you shall
promptly return the equipment to the District.

The equipment must be returned to the District by the return date indicated. Failure to return the equipment to the
District by that date will result in the District charging you the full replacement cost of any equipment not returned.
Returned equipment is expected to be in good working order and the same condition as when it was issued, taking into
consideration normal wear and tear.

THE DISTRICT MAKES NO WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, REGARDING THE EQUIPMENT
PROVIDED. UNDER NO CIRCUMSTANCES IS THE DISTRICT RESPONSIBLE TO YOU OR ANY THIRD PARTIES FOR
ANY DIRECT, INDIRECT OR CONSEQUENTIAL DAMAGES, LOSSES OR COSTS CAUSED BY OR ARISING FROM ANY
USE OF THE EQUIPMENT, INCLUDING ANY LOSS OF DATA.

To the maximum extent permitted by law, you shall indemnify the District against any claim, cause of action, judgment, loss,
demand, suit, or legal proceeding brought against the District or its officers, employees, representatives, or agents, which
arises directly or indirectly from your use of the equipment.

Please note that there will be an equipment charge placed on your students account in Infinite Campus for the cost of
the equipment you will be borrowing. These charges will be removed upon the return and inspection of the equipment.

__________________________ _________________________ _______________

Student Name Student Signature Date

__________________________ _________________________ _______________

Parent Name Parent Signature Date

_________________________________ _______________________________ ____________________

Description Serial Number RTMS Number

DATE RETURNED: _________________