• Optional Forms

    These optional forms can be signed in our Guide to Student Conduct. Please contact your child's school principal for a copy.


    Directions: The forms below are OPTIONAL. If you are returning these forms, please submit no later than August 21, 2020 or 5 days after enrolling in school.

    Student Insurance – Sign if you would like to purchase insurance

    By not signing below, I attest that I was offered student insurance for my student and DO NOT want to purchase it. By signing below, I state that I wish to purchase insurance and have enclosed application and payment. I understand the policy does not take effect until the application and payment are returned.

     

    Parent/Guardian Name (Print):________________________________                                                                 

    Parent/Guardian Signature:___________________________________

     


    Military Affiliation – ONLY students with a parent/guardian with military affiliation

    The federal Every Student Succeeds Act (ESSA) requires school districts to report to the state of Louisiana if a student has military affiliation. If a student’s parent or guardian is active duty military, active duty military reserves, or retired military, the student should be reported as having military affiliation.

    Student’s Name:____________________________

    Student’s School:____________________________

    Parent/Guardian’s Name with Military Affiliation:_______________________

    The above parent/guardian is:

                ___ Active duty military

                ___ Active duty military reserves

                ___ Retired military (doesn’t apply to ONLY completed tours)


    Release of Personally Identifiable Information

    By signing below, parent/guardian is requesting to withhold directory information, which is defined by the St. Bernard Parish School Board as a student’s name, address, date and place of birth, telephone number (if it is listed), grade level, electronic mailing address, photographs, participation in officially recognized activities and sports, weight and height of members of athletic teams, degrees and awards received, participation in official school- sponsored activities, and most recent previous educational agency or institution attended.

    The primary purpose of the directory information is to allow the district to include information from your child’s educational records in certain school publications. Directory information can also be disclosed to outside organizations without a parent’s/guardian’s written consent. Outside organizations include, but are not limited to, companies that manufacture class rings or yearbooks, colleges and post-secondary institutions, and military recruiters.

    By signing below, parent/guardian is requesting to WITHHOLD directory information in accordance with the Family Education Rights and Privacy Act (FERPA). By signing, your student’s name will be removed from all school related publications including playbills, graduation announcements, athletic rosters, yearbooks, and honor roll lists. Your student’s name will also not be shared with outside agencies for purposes such as recruiting and scholarships.

     

    Parent/Guardian Name (Print):________________________________                                                                 

    Parent/Guardian Signature:___________________________________


    District Media Release – Sign ONLY if you DO NOT WANT

    St. Bernard Parish School District utilizes the benefits of modern media and technology. Your child’s image may appear in videos, television programs, commercials, websites, social media, audiotapes, pictures, brochures, and/or newspapers. By NOT signing below, you jointly and generally forever release, discharge, acquit, and forgive the St. Bernard Parish School Board and its employees from any and all claims, suits, agreements, liabilities, and proceedings of every nature and description both at law and in equity from the use of undersigned’s image in any public medium.

    Please sign below if you DO NOT WANT your child to appear in any videos, television programs, commercials, websites, social media posts, audiotapes, pictures, brochures, and/or newspapers.

    Parent/Guardian Name (Print):________________________________                                                                 

    Parent/Guardian Signature:___________________________________