Student Learning Management System

Student Learning Management System Enrollment and Consent Form

Student Name:    Date of Birth:    Student ID:

Contact Information

Enrollment Details

Program Start Date:    Expected Completion/Graduation:

Device & Accessibility

Will student access the LMS primarily by: School-issued device Personal device Shared household device

Emergency & Medical Information

Parent / Guardian (If Student Is Minor)

Student is under 18:

Policies, Consents, and Acknowledgements

Account and Acceptable Use: I acknowledge that the LMS account issued to the student is for authorized educational purposes only. The student will not share account credentials and will comply with the institution's acceptable use rules. I understand that violations may result in temporary or permanent suspension of access and disciplinary action under academic conduct procedures.

I acknowledge and agree to comply with acceptable use and academic integrity obligations.

Data Collection and Privacy: By enrolling, I consent to the collection, storage, and use of student data within the LMS for educational, assessment, and administrative purposes. This includes course activity logs, grades, submissions, and communications. Data may be retained according to institutional record retention schedules and used for accreditation, assessment, and required reporting.

I consent to the collection and use of data as described above.

Third-Party Tools and Recordings: The LMS may integrate third-party educational tools and may record synchronous sessions for pedagogical purposes. Recordings may include audio, video, and screen captures. Recordings are retained for instructional use and not for public distribution without additional consent.

I give consent for the use of third-party tools and instructional recordings as described.

Electronic Communication and Notifications: The institution will send course announcements, grade notifications, and administrative communications to the supplied email and phone. Standard message and data rates may apply for SMS.

I consent to receive email notifications. I consent to receive SMS/text notifications.

Intellectual Property and Use of Student Work: Student submissions (assignments, projects, and other materials) remain the student's intellectual property unless otherwise specified in course materials. The institution is granted a non-exclusive license to reproduce and display student work for educational, accreditation, and promotional purposes unless the student provides written objection.

I acknowledge the intellectual property terms above.

Disciplinary and Liability Provisions

The institution reserves the right to suspend or terminate LMS access for breaches of policy or misconduct. Academic penalties, including grade adjustments, course failure, or referral to student conduct, may apply for academic integrity violations. The institution disclaims liability for interruption of service, data loss caused by third parties, or misuse of accounts. This does not limit rights provided by applicable law.

Certification: I certify that the information provided on this form is true and complete to the best of my knowledge. I understand that providing false information is grounds for withdrawal of access and further disciplinary action.

Additional Information

Acknowledgment and Signature

By signing below, the signer acknowledges that they have read, understood, and agree to the terms, consents, and policies set forth in this form. If the student is a minor, a parent or legal guardian must sign.

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