ACC Liability Release updated

1. ACC Dual Credit Student
Vehicle Transportation Form and Release of Liability
Student Name: ________________________________ LISD Student ID#: ______________
The student listed above is participating in the Austin Community College (ACC) Dual Credit Program at
Rouse High School. All ACC Classes scheduled at RHS will meet during the school day and will have
frequent Fridays off, or other days that ACC does not meet. Additionally, some classes are scheduled during
3rd & 7th periods, which fall in the middle of the school day. These classes, while offered on the Rouse High
School Campus, are college-level courses conducted by ACC Faculty.
By signing below, you acknowledge that during your student’s ACC class time, he/she is considered an ACC
students for the purposes of enrollment. You further acknowledge that your student’s participation in the
ACC Dual Credit Program will require him/her to independently manage himself/herself when classes are
cancelled, released early, or no class is offered. As such, you agree that Leander Independent School District,
Rouse High School, and the teacher, staff and administration are not liable for any accident or injury that
may occur during the ACC class period.
Rouse High School is a closed campus. However, we are offering the opportunity for students enrolled in the
ACC Dual Credit Program to request permission to leave campus during times when classes are not offered.
Please indicate below whether or not you would like to request permission for your student to leave campus.
_____ YES _____ NO
_____ YES _____ NO
_____ YES _____ NO
Students failing to return this signed form are required to stay on-campus during the entire ACC period
within the designated campus locations (RHS Library). Accumulation of excessive tardies and/or absences
for the class periods preceding or following the ACC period may result in disciplinary action and revocation
of these privileges.
Parent / Guardian Name _________________________________________________________
Parent / Guardian Signature: ______________________________ Date ___________________
Student Signature: _____________________________________ Date ___________________
I request that the student listed above be allowed to leave the Leander
campus during times when his/her ACC course is not is session or ends early.
I hereby give permission for the student listed above to transport fellow
students in his/her personal vehicle to and from campus during the ACC class
period.
I hereby give permission for the student listed above to ride with fellow
students to and from campus during the ACC class period.
Ahsan Elai Joyo a2177786
X
X
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Maqsood Joyo
5/3/2021
5/3/2021