PARENTAL CONSENT FORM (1 OF 3)

PARENTAL CONSENT FORM (1 OF 3) 

Account Information 

Email: forms@giantcampus.com 

Fax: 206.452.5945 

3131 Elliott Ave., Suite 790 

Seattle, WA 98121 

www.giantcampus.com/wa 

Student Name: Student Birth Date: 

Student Email: Gender: Male Female 

Parent Name: 

Parent Phone: 

( ) 

MM/DD/YYYY 

Parent Email: 

Last Public School Attended (if applicable): 

Release Form 

I have requested to allow my child to participate in a Giant Campus of Washington course. As a condition of receiving this benefi t, I, the 

undersigned do hereby agree to the following: 

I understand that my child’s participation in this activity can expose them to dangers both from known and unanticipated risks. 

Acknowledging that such risks exist, I hereby release and discharge Giant Campus, its offi cers, agents, and employees from any and all 

claims or liability for personal injury or property damage suffered while participating in the activity; including, but not limited to, any claim 

arising out of any condition of the premises at which the activity is held or the conduct of any person in connection with the preparation 

for, supervision of, or conduct of any activity, whether planned or unplanned. 

I specifi cally agree to release and hereby release Giant Campus and the offi cers, agents, and employees of the program for any 

negligence of the program, or its offi cers, agents or employees. 

Initial ________ 

PR Release Agreement 

I give permission for Giant Campus of Washington or media crews to use screenshots or screen capture which may include portions 

of projects, work or communications by my child. Use of the images includes, but is not limited to PR, brochures, media coverage, 

YouTube, and slide or video presentations, where it is understood that my child’s name is held private, and where the sole purpose is 

to promote Giant Campus, or its related programs. 

YES, Initial ________ 

NO, Initial ________ 

Hardware/Software Policy Agreement 

I understand there are minimum technical requirements necessary for successful participation in Giant Campus of Washington courses 

and that these requirements may vary by course. It is the student and family’s responsibility to obtain and/or maintain computer 

hardware and Internet services which support the registered course. It is understood that some courses require the purchase or 

download of specifi c software and that obtaining course software is the responsibility of the student and family. 


Acceptable Behavior Policy Agreement 

The Giant Campus of Washington discipline policy is directed toward the goal of maximizing the growth and development of the 

students and for protecting the group and individuals within. It is anchored by our expectation that students will conduct themselves in a 

manner that promotes respect for themselves and respect for others. 

All students have the right to participate in an environment that is safe, enjoyable and conducive to a great learning experience as well 

as to receive clear and prompt feedback on behavior. If a particular student’s behavior is negatively impacting the emotional or physical 

safety or learning of others, Giant Campus of Washington will take disciplinary measures, including, in extreme situations, removal of 

the student from the course. 

I understand that my student will be asked to abide by the policies and procedures of Giant Campus of Washington, which include but 

are not limited to acceptable computer use, appropriate online communication and the Honor Code at all Giant Campus of Washington 

events and activities. Failure to do so may result in disciplinary actions. 

Initial ________ Continued >> 

Giant Campus of Washington - Parental Consent (for all students)



Fax: 206.452.5945 




Student Name: 

Family Educational Rights and Privacy Act (FERPA)* 

Giant Campus of Washington complies with the Federal Educational Rights and Privacy Act, a federal law that protects the privacy of 

student education records. 

YES, Giant Campus of Washington may share directory information about my student including name, address, telephone number, 

birth date, honors and awards and dates of attendance. 

NO, I do not grant Giant Campus of Washington permission to share directory information about my student including name, 

address, telephone number, birth date, honors and awards and dates of attendance. 


Individual User Access Informed Consent and Release Form 

By registering for a Giant Campus of Washington course, I acknowledge that my child has working knowledge of the Internet, and 

I permit use of it as a tool for education and community building. As consideration for the privilege of using the network and in 

consideration for having access to the public networks: 

• I hereby release Giant Campus and other intermediary providers, if any, and operators, and any institutions with which 

they are affi liated from any and all claims and damages of any nature arising from my, or my child’s use, or inability to 

use, the Giant Campus network or Internet. 

• Giant Campus shall have the right to review, edit, or remove any materials installed, used, stored, or distributed on or 

through the network or Internet system, and we hereby waive any right of privacy, which my child or I may otherwise 

have on such material. 

• Giant Campus shall have the right, without further compensation, to copy, edit, modify, use, publish and distribute all 

or portions of students’ work, and to use students’ work, for promotional and other purposes. 


Continued >> 




Fax: 206.452.5945 




Student Name: 

PLEASE ANSWER QUESTIONS 1A OR 1B AND QUESTION 2 

QUESTION 1. A. Is your child of Hispanic or Latino origin? (if so, check all that apply) 

CUBAN 

MEXICAN/ MEXICAN AMERICAN/ CHICANO 

DOMINICAN 

CENTRAL AMERICAN 

SPANIARD 

SOUTH AMERICAN 

PUERTO RICAN 

LATIN AMERICAN 

OTHER HISPANIC/LATINO 

QUESTION 1. B. Child is not Hispanic/Latino 

NOT HISPANIC/LATINO 

QUESTION 2. What race(s) do you consider your child? (Check all that apply) 

AFRICAN 

AMERICAN/BLACK ALASKA NATIVE 

CHEHALIS 

WHITE 

COLVILLE 

COWLITZ 

ASIAN INDIAN 

HOH 

CAMBODIAN 

JAMESTOWN 

CHINESE 

KALISPEL 

FILIPINO 

LOWER ELWHA 

HMONG 

LUMMI 

INDONESIAN 

MAKAH 

JAPANESE 

MUCKLESHOOT 

KOREAN 

NISQUALLY 

LAOTIAN 

NOOKSACK 

MALAYSIAN 

PORT GAMBLE KLALLAM 

PAKISTANI 

PUYALLUP 

SINGAPOREAN 

QUILEUTE 

TAIWANESE 

QUINALT 

THAI 

SAMISH 

VIETNAMESE 

SAUK-SUIATTLE 

OTHER ASIAN 

SHOALWATER 

SKOKOMISH 

NATIVE HAWAIIAN 

SNOQUALMIE 

FIJIAN 

SPOKANE 

GUAMANIAN OR CHAMORRO SQUAXIN ISLAND 

MARIANA ISLANDER 

STILLAGUAMISH 

MELANESIAN 

SUQUAMISH 

MICRONESIAN 

SWINOMISH 

SAMOAN 

TULALIP 

TONGAN 

YAKAMA 

OTHER PACIFIC ISLANDER 

OTHER WASHINGTON INDIAN 

OTHER AMERICAN INDIAN 

I, , (Parent or Guardian’s name) have read 

and understand the contents of Giant Campus’s Parental Consent Form and will abide by its Terms and Conditions. 

Parent/Guardian Signature: Date: 

Relationship to Participant: 

X 

MM/DD/YYYY 

This form is the property of Giant Campus, and confi dentially held on fi le. The completion of this form is required to fi nalize registration 

for Giant Campus of Washington courses and programs. Students returning to Giant Campus of Washington must resubmit this form 

annually. 

*20 U.S.C. § 1232g; 34 CFR Part 99

PARENTAL CONSENT FORM (1 OF 3)

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