Guardians Acknowledge the Following:
I have read and understand the District Student Code of Conduct.
If accepted, I consent to the enrollment of my student in a Work-Based Learning Program in Jefferson County Public Schools.
Transportation Consent: I understand that the WBL programs do not provide transportation, and confirm that my child has transportation to/from the worksite. I expressly release the Work-Based Learning program work site, local school, and Jefferson County Public Schools and any agents of the employer or the school system from any liability that may result from my student’s use of his/her individual transportation or any other mode of transportation my student utilizes to meet this requirement.
Photo/Media Release: The WBL Coordinator and/or employer may wish to photograph participants in the program for promotional and/or educational purposes. I hereby give my consent to all Work-Based Learning photographs, audio recordings, and/or video recordings taken of me or my minor child by Jefferson County Public Schools or their designee. I understand that any photographs, audio recordings, and/or video recordings become the property of the local school/district/designee and may be used by the school, district, or others with the consent, for educational, instructional, or promotional purposes determined by the district in broadcast and media formats now existing or to be created in the future.
Treatment Consent: I hereby authorize the school or work-site supervisor/mentor to secure emergency medical treatment. I will assume all financial responsibility.
Insurance: I acknowledge and affirm that it is my responsibility to ensure my student is covered by medical/accident insurance throughout the duration of their participation in Work-Based Learning.
WBL Students are Expected to:
Be on track for graduation.
Be courteous and considerate of the employer, co-workers, and others.
Be punctual, dependable and loyal.
Keep the employer’s best interest in mind.
Maintain regular attendance, both in school and at the WBL placement.
Notify the employer and the WBL Coordinator as soon as possible if you are not able to attend work.
Complete all forms and documents required in the WBL program.
Keep records of work experiences and wages earned (if applicable) as required by JCPS and submit them on or before specified deadlines.
Conform to the policies, procedures and regulations of the employer and JCPS.
Maintain a satisfactory performance level during the WBL placement.
Consult the WBL Employer and WBL Coordinator about any difficulties at the WBL placement.
WBL Students Acknowledge the Following:
enrollment in a Jefferson County Public Schools Work-Based Learning (WBL) program is limited and that submitting an application for enrollment does not mean that I will automatically be accepted;
my grades, discipline record, and attendance record may be checked by the WBL Coordinator and other JCPS officials prior to acceptance into the program;
all enrollment forms and documents must be completed and submitted prior to final acceptance into the program;
I must respond to all inquiries from school officials regarding my application in a timely manner;
I must maintain health coverage for the duration of the placement (if I do not have health coverage, I can speak to my school counselor or visit KCHIP);
I must secure a placement prior to enrollment in a Work-Based Learning program;
if I drive to/from the placement and lose my driver’s license and/or auto coverage, other transportation and/or renewal of coverage will be required to continue participation in the program and will be my and/or my guardian(s) responsibility;
if, after the semester begins and I am removed from or leave my placement, I will be required to request a schedule change and will be enrolled in regular classes with a regular class schedule (grace periods may vary but will not exceed 2 weeks);
all relevant parties (including but not limited to myself, my employer, school officials, and my guardians) must comply with district, state, and federal requirements before, during, and after the Work-Based Learning placement and failure to do so may result in a rejected application or removal from a placement;
once accepted, I must complete all required training (from employer and/or JCPS) within the first 2-3 weeks of the placement;
once accepted, I must complete and submit all required forms and documents for the duration of the placement; and
once accepted, I must submit a monthly work log for review and verification, and failure to do so may result in my removal from the Work-Based Learning program.
See WBL Programs for further WBL Requirements.
See Liability Checklist for more on liability.