Damage/Replacement Form for Circuit Playground

I am curious if anyone created or is using a permission/release/notice form? I have some immature students that think nothing of dropping their laptops on the floor. I am concerned that once they start using the circuit playgrounds there is a chance that that same attitude will be used with this equipment. I would like to send a form home indicating that each student will be assigned the same unit for the entirety of the unit and that the student that is assigned that unit is responsible for its proper care and use. I also want parents to know that they will be held financially responsible for the replacement of any boards that are damaged through improper use of the equipment.

If anyone has such a form I would appreciate getting a copy of it.


Irresponsible kids usually have irresponsible parents. A signed release means nothing to them as they will make excuses for their children’s behavior or go into denial. Responsible parents do not need a release form as they will accept your word and compensate you. If they are willing to drop laptops perhaps they should not be allowed to participate. I say this as a veteran woodshop/technology teacher.

Someone thought it would be cute to jam gum in the cabinet for the tower PC so they could play Minecraft…let me know if you need the few page form I created. Using that next year at the beginning of the year. When kids do that and I have to create a “policy” the kids know someone done messed up.

Here you go…

Desktop PC Workspace Daily Agreement Sign off form
By signing this agreement form you agree to items listed on the XXX Computer Coding Course Spring 2018 - Device and School Property Agreement Form.

Computer towers in the classroom and workspaces. Students agree to not damage or alter the workstations or school equipment. Any damage or altering of the cabinet doors, cables, monitor, PC, etc. are not limited to those devices. Students will complete the sign in form daily before being to log into the school computer.

Each student is responsible for notifying YOUR NAME on anything such as locks to the cabinet doors being damaged, computer damage, or technical issue immediately.
Students are responsible for the workspaces and if Ms. Barber or the next class the student notice(s) the workspace to be damaged or not picked up, the parental guardians will be notified immediately.
If a student is caught damaging school property, the student will be reseated, and an incident form will be completed with the teacher and student on the incident(s). Depending on the severity of the damage, Ms. Barber has the right to request administration to investigate and request a Student Discipline Referral form.

Students are expected to shutdown the PC before end of class and report any damage or technical issue below.

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Thank you for sharing this form.