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Cyberbullying Agreement Form

[Your School Letterhead]

Parental Agreement Form: Cyberbullying Incident Reporting

Dear Parents/Guardians,

At [School Name], we are committed to providing a safe and respectful learning


environment for all students. In line with this commitment, we recognize the importance of
addressing and preventing cyberbullying incidents. Cyberbullying can have a significant
impact on a student's emotional well-being and academic performance. To promote a safe
online environment and ensure the welfare of our students, we request your cooperation in
reporting any cyberbullying incidents involving your child.

Please read the following agreement carefully and acknowledge your understanding and
commitment by signing below:
Parental Agreement:

I, [Parent/Guardian Name], understand that cyberbullying includes but is not limited to the use of
electronic communication devices such as computers, smartphones, and social media platforms to
harass, intimidate, or threaten another student.

I am aware that cyberbullying can have severe consequences on my child's emotional health and
academic performance.

I commit to actively monitor my child's online activities, including their social media accounts and
text messages, to the extent allowed by law and with respect for their privacy.

In the event that my child is involved in a cyberbullying incident or becomes aware of such an
incident involving another student, I agree to promptly report it to the school authorities. I
understand that timely reporting is essential for addressing and resolving such incidents effectively.

I understand that the school will take appropriate steps to investigate and address reported
cyberbullying incidents, including but not limited to counseling, disciplinary actions, and involving
law enforcement when necessary.

I agree to support the school's efforts to educate my child about responsible online behavior and the
potential consequences of cyberbullying.

I understand that this agreement is intended to promote a safe and respectful online environment
for all students and that my cooperation is crucial in achieving this goal.

Parent/Guardian Information:

Parent/Guardian Name: _________________________


Student Name: _________________________
Grade/Class: _________________________
Contact Email: _________________________
Contact Phone Number: _________________________

Signature: _________________________ Date: _________________________

Please return this signed agreement to the school office as soon as possible. Your commitment to
addressing cyberbullying incidents will help create a safer and more supportive learning
environment for all students.

Thank you for your cooperation in ensuring the well-being of our students.

Sincerely,

[Principal's Name]
[School Name]
[School Address]
[Phone Number]

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