Parent Permission Form for Student Video about BYOTs Dos and Do Nots

August 8, 2016
Dear Parent or Guardian:
This year at Double Churches Middle School, we are implementing a program called Bring Your
Own Technology, also referred to as BYOT. This program allows students to bring personal
devices such as cellular phones, e-readers, tablets, and laptops to their classes strictly as
instructional aids and with their teachers permission. In order to model for students what the
expected behaviors are when participating in BYOT, we have decided to create a video using
students to portray different Do and Do Not scenarios. We are excited to welcome BYOT into
our school and look forward to working with your child to create a video that will be shown to
students for many years to come. If you have any questions about BYOT or the production of
this video, please contact the school at (706) 748-2678.
Sincerely,
Double Churches Middle Schools faculty and staff

If you want your child, ____________________, to participate in the production of this

video, please sign on the line below. Separate this portion of the form using the above
line, and have your child return the permission slip to his/her homeroom teacher.

Parent/Guardians Printed Name

Signature

Date