Course Approval AND Parental Consent and Waiver for Dual Credit/ Exceptional Admission Students Age 17 or Younger - Completion Form

Sep 27, 2026

Uploaded by SANS

Course approval and parental consent/waiver form for Dual Credit and Exceptional Admission students aged 17 or younger. Includes program selection for multiple pathways (e.g., Dual Credit High School, Home School, College Academy, Exceptional Admit). Collects student identification, acknowledges college conduct and policy compliance, and addresses potential impacts on financial aid and enrollment. Parent/guardian certification grants consent, acknowledges facility risk and waives claims, covers financial responsibility and FERPA record access limits, and includes high school principal approval sections, term enrollment tracking, and required test scores and IDs.

LanguageEnglish

CategoryExam

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Program and Student Information

Student and Parent/Guardian Consent

High School Principal Approval

Course Selections and Term Details

Lone Star College Office Use

Enrollment Tracking and Waiver Eligibility

Course Approval AND Parental Consent and Waiver for Dual Credit/ Exceptional Admission Students Age 17 or Younger For LSC Office Use Only: Check the Appropriate Program: ✔ Dual Credit High School (DCHS) Dual Credit Home School (DCHMS) ☐☐ Dual Credit College Academy (DCCA) Dual Credit College Academy Early College High School (EAEC) ☐☐ EA (Exceptional Admit) EAACL (Exceptional Admit – Accelerated) | Type
or
Print | Name of Student: LSC ID\# DOB: / /
Current Grade
Current School: Level: HS ID\# HS Graduation Date (MM/YYYY): / | | --- | --- | | | I understand that if I am admitted under this program, that a college level standard of conduct is required, It is my responsibility to comply with the admission policies, student code of conduct, policies, academic standards of LSC, and standards set forth in the course syllabus. I understand that enrolling in certain courses could negatively affect financial aid, scholarships, future enrollment, tuition costs, etc. I also understand that academic information such as test scores and college transcripts will be provided by LSC upon request to my corresponding high school.
( ) Student Signature Daytime Phone Number | To be Completed by Parent or Legal Guardian I, , hereby certify that I am the parent or legal guardian of the above named Student and I have read and understand the above statements and agree to the terms and stipulations. I hereby grant my consent for the above named student to enroll in classes at LSC. ☐ I acknowledge that Student’s use of the facilities may expose Student to hazards or risks that may result in Student’s illness, personal injury, or death, and I understand and appreciate the nature of such hazards and risks. In consideration of Student being permitted to participate in courses at LSC and use the LSC facilities (“facilities”), I, on behalf of myself and Student, hereby waive rights to sue, assume all risks and release the College, its trustees, and employees from all claims for injury, illness, death, property damage, or other loss arising from Student’s participation in courses or use of the facilities. ☐ I understand the student will be responsible for any charges remaining on his/her account not covered by any applicable waivers and is subject to LSC’s Student Financial [Responsibility Agreement:](Responsibility Agreement: www.lonestar.edu/departments/financetreasury/LSCS)[ ](Responsibility Agreement: www.lonestar.edu/departments/financetreasury/LSCS)[www.lonestar.edu/departments/financetreasury/LSCS](Responsibility Agreement: www.lonestar.edu/departments/financetreasury/LSCS) Financial Responsibility Agreement. pdf ☐ I understand the student may be exposed to adult material in the classroom and open laboratories, including libraries, learning centers and computer labs.☐ I understand that once the student is registered in a college course, he/she controls access to his or her educational records under the Family Educational Rights and Privacy Act (FERPA) and—unless an exception applies—I may not have access to my student’s records without his/her written permission or proof that I claimed the student as a dependent on my most recent income tax return. ☐ I understand that students who receive a D or F in a dual credit course are not permitted to continue in the dual credit program. ☐ I understand that if my child is aged 15 years or younger, I hereby assure that I (parent, legal guardian, or authorized responsible adult) will be available on the college campus (but not in the student’s classroom) to monitor his/her activities outside of class, in the library, and in open labs in case of emergency. ☐ For College Credit Only: I understand the high school is not required to count the college course towards high school graduation requirements. I understand the student cannot register for a college credit only course conflicting with the class schedule at the high school. My

FAQs

What does a parent or legal guardian authorize in this form?

The parent/guardian certifies they have read the statements and grants consent for the student to enroll in classes at LSC, including acknowledgment of facility risks and related waiver terms.

What risks does the waiver address for students using LSC facilities?

The form states that using LSC facilities may expose the student to hazards or risks that could result in illness, personal injury, or death, and it releases the college, trustees, and employees from related claims.

What approvals and materials are required for Dual Credit registration?

Official test scores are required for Dual Credit registration and must be attached to the form. The high school principal (or designee) must approve course selections, and LSC office use sections track term and waiver-eligible hours.

Sep 27, 2026

Uploaded by SANS