Traveling to School Information Form for CLES Families Living in the Non-Transported Area 
The purpose of this form is to connect CLES families who live in their immediate neighborhood in the areas that do not receive bus service. The benefits of CLES families becoming connected and informed of other CLES families who live nearby include:
  • The ability to coordinate transportation to school, including bike-to-school groups ("bike train"), and "walking school bus" groups, where a group of CLES students can walk to school together with one or more adults.
  • Increased social connectedness with other CLES families who live in the same neighborhood.
  • Ability to share and receive contact information with neighboring families in a secure and small group manner.
  • Ability to contact your neighbors in the case of an emergency.
CLES staff and leaders are not able to directly share a family's personal information (such as email, phone number, home address, names of children) with other families without parent consent. Therefore, this form is a way families can opt in to having their information shared with other families who live in their immediate neighborhood. 

Completing this form is totally optional, and families can indicate what personal information they are comfortable sharing by completing the form below.

In addition, CLES is looking for CLES parents or guardians to serve as "Neighborhood Group Coordinators" who would be willing to help coordinate the sharing of family contact information in their immediate neighborhood or street and help to spread the word about joining a CLES neighborhood group. Please indicate below if you would be willing to serve in this role.

Sign in to Google to save your progress. Learn more
Email *
By checking the box below, I give my consent for CLES administrators to share the personal information I have provided in this form above with other CLES families who live in my immediate neighborhood, and who have also consented to sharing their personal information. *
Record the name of the person giving consent to share contact information as described above. 
Record the date on which the person provided consent to share contact information as described above. 
Name of Parent/Guardian/Caretaker #1 *
Parent/Guardian/Caretaker #1 Email *
Parent/Guardian/Caretaker #1 Cell Phone Number *
Name of Parent/Guardian/Caretaker #2
Parent/Guardian/Caretaker #2 Email
Parent/Guardian/Caretaker #2  Cell Phone Number
Name(s) and Grade (s) of CLES student(s) who reside at your home. 
Example: Tracey Albright, 4th grade 
 *
On which street do you reside in the non-transported area for CLES?  
 *
What is your home address? *
CLES Neighborhood Group Coordinator 
A group coordinator helps coordinate and communicate family contact information in their immediate neighborhood or street,  helps to spread the word about joining the CLES neighborhood group, and identifies a meet-up time and location.
 *
Walk to School Participation
Please indicate your interest in joining a group walking to and from school. A walking group would consist of a group of children meeting up at a designated location and time to walk to and from school together with one or more adults accompanying the group. 
 *
Captionless Image
Required
Walk to School Participation
If you are interested in the walk-to-school group, select the option that works best for your family.  *
Captionless Image
Required
Bike to School Participation
Please indicate your interest in joining a group biking to and from school. A biking group would consist of a group of children meeting up at a designated location and time to bike to and from school together with one or more adults accompanying the group.
 *
Captionless Image
Bike to School Participation
If you are interested in the bike to school group, select the option that works best for your family.  *
Captionless Image
Required
Additional comments, suggestions, or ideas (optional)
Learn More About Walk-Bike to School for CLES Families by scanning the QR code.  We are developing the site and would love to know what else you are interested in us building out or including.   Please list all suggestions and feedback below: *
Captionless Image
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Howard County Public School System. Report Abuse
Google Forms