Agmt21 Redwood City School District

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Attachment C request. Consent forms must contain this language: I, the parent or legal guardian for hereby give my permission to the Redwood City School District (RCSD) to release information from my child's education records (listed below) to authorized staff from the (CONTRACTOR) to support the Out -Of -School Time services provided to my child. Additionally, I grant permission for teachers, counselors and other school staff to verbally communicate any academic information regarding my child to the representatives of CONTRACTOR in order to best support my child's achievement. I authorize the RCSD to share the following categories of information with CONTRACTOR: • State -assigned Student ID # -- SSID • CAASPPISBAC score • School ID • EL designation • Beginning of year, middle of year, and end -of -year reading and math proficiency levels • Beginning of year, middle of year, and end -of -year reading and math performance bands 0-8thgradestudents'GPA • Student attrition and retention (students'start and end dates in district) • Attendance (tardies, absences)- Number (#) of instances • Behavioral referrals (#) of instances • Student and Family/caregiver names and contact information • Student grades, assignments and other educational information I further authorize the RCSD to provide CONTRACTOR with real-time access to the above -listed information through its electronic student information system, PowerSchool. This authorization is valid for as long as my student receives services from CONTRACTOR, unless my consent is revoked earlier in writing. Timing of Data Request and Return CONTRACTOR runs its programs during the school year and the summer. Therefore, it will be able to submit a unified annual data request in June, September, December, and March of each year (including for students who participated over the previous school year and/or summer). The data requests will be submitted by the I" day of the months identified. CONTRACTOR will compile its data request electronically. CONTRACTOR will also share its set of student data with the District in August/September, January, and June. RCSD will provide the data in the form REV: 07-15-21 RL AT-rY/AGR.2021.187/Redwood City School District (2021-2022 After School Agreement) Page 19 of 24