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Parent Acknowledgement Form

Weld County District Attorney Diversion Form

* Required Fields

By digitally signing this form, I hereby acknowledge the receipt of the following documents from the Weld County District Attorney Diversion Program:

 * Popular Social Media Apps –What Are They and How Are Teens Using Them? 

 * Sexting. Looks Fun. Not Worth It.

 * Cyberbullying – How Do I Comfort My Teen? I’m Cyberbullied. What Can I Do?

 * Slang Terms Parents Should Know

AGREEMENT: By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.

* Parent First Name: 

* Parent Last Name: 

Child's First Name: 

Child's Last Name: 



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