Permission Slip to Walk Home (3rd

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Permission Slip to Walk Home (3rd – 5th grade only)

This permission slip is only valid for the 2021-2022 school year.

Student Name (Last, First) *

Student Grade Level *

Parent/Guardian Name *

By completing this waiver, I authorize my child (listed above) to walk home or walk to the places I have designated below. Please note that this permission slip grants permission for this child to leave school at dismissal time without adult supervision.Students may walk home or go to the places designated below, only when a permission slip is signed, dated by parent or guardian, and is on file at the school. If we do not have this slip, your child will not be released. Your child will be sent to the office where you or someone from the emergency contact list will need to provide photo identification (California ID, Driver’s License, or Passport) to pick up the student. *

By clicking here, I authorize my child to walk home or to walk to the places I have designated below.

Required

Please note the all names of any additional younger siblings that will be walking with the student named above: Student Name, Grade level, Teacher (Ex. John Smith, 1st Grade, Mrs.Padilla) *

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