Please read this document carefully

 Parent/Legal Guardian Permission Agreement

Home Services Computer Policy Internet Use

We encourage all parents and children to read Child Safety on the Information Highway from the National Center for Missing and Exploited Children, or read Child Safety and the Internet from EarlyChildhoodEducation.com

Parents should remind their child to be careful not to expose themselves to dangerous situations when using email and all other forms of electronic communication. The use of chat rooms, instant messaging, discussions groups, newsgroups and game rooms are prohibited.

As the parent or legal guardian of the minor child listed below, I have read and agreed to comply with the library's Policy for Access to Internet Resources and the Internet Acceptable Use Agreement. Please check the appropriate box below:

____ I agree to sit with and supervise my child twelve and under while he/she accesses the Internet.

____ I agree to sit with and supervise my child age thirteen to seventeen while he/she accesses the Internet.

____ I accept the responsibility and agree to allow my child age thirteen to seventeen to use the Internet unsupervised.

I hereby grant permission for my child to access the Internet at Cleveland County Library System.

Parent's name _____________________________________________

Parent's signature __________________________________________

Child's name ______________________________________________

Child's age _________

Birth date _____________________

Address ___________________________________________________

__________________________________________________________

Phone number ______________________________________________

Date _________________

Staff signature ___________________________________________


This form will be available at the front desk.

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