Waived Coverage. You agree to pay for the repair or replacement of the device at a cost not to exceed replacement value of the Chromebook/iPad ($300) should the device be damaged in any way. The replacement cost must be provided before an additional device is checked out to your student. If parents/guardians waive the Technology Device Protection Plan, parents/guardians accept full responsibility for any loss, theft or damage to the device and accessories while issued to their student. In the event the device is returned damaged, all costs and fees related to the collection of the cost of repair (including legal counsel, postage, process server, filing fee, court costs, etc.) will be the parent’s responsibility. I agree to purchase the Technology Device Protection Plan for the current school year and follow the conditions as outlined above. $20 cash or a check made out to “Shamokin Area SD” is attached. I waive the option of purchasing the Technology Device Protection Plan and take full responsibility for the device. ■ Chromebook/iPad: $350.00 Missing Power Supply: $30.00: Chromebook Screen $50.00. iPad Screen $150 ■ Repair Costs: $50.00 will be charged for required repairs due to negligence, abuse etc. School Year Teacher Name (For Elementary) Student Name Student Signature Date Parent/Guardian Name Parent/Guardian Signature Date
Waived Coverage. The parent/guardian agrees to pay for the repair or replacement of the device at a cost not to exceed the initial value of the Chromebook should the device be stolen, lost or damaged in any way. The replacement cost must be provided before an additional device is checked out to your student. If parents/guardians waive the Technology Device Protection Plan, parents/guardians accept full responsibility for any loss, theft or damage to the device and accessories while issued to their student. In the event the device is returned damaged, all costs and fees related to the collection of the cost of repair (including legal counsel, postage, process server, filing fee, court costs, etc.) will be the parent’s responsibility. I have attached a $20.00 CHECK made out to DASD, or I have attached $20.00 CASH, and I agree to purchase the Technology Device Protection Plan under the conditions outlined above. I waive the option of purchasing the Technology Device Protection Plan. Print Student Name Student Signature Date
Waived Coverage. You agree to pay for the repair or replacement of the device at a cost not to exceed the initial value of the Chromebook should the device be stolen, lost or damaged in any way. The replacement cost must be provided before an additional device is checked out to your student. If parents/guardians waive Technology Device Protection Plan, parents/guardians accept full responsibility for any loss, theft or damage to the device and accessories while issued to their student. In the event the device is returned damaged, all costs and fees related to the collection of the cost of repair (legal counsel, postage, process server, filing fee, court costs, etc.) will be the parent’s responsibility.
