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Trailblazer Parent Form
This form is intended to capture parent permission for students to participate in the Trailblazer program.
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* Indicates required question
Date
MM
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DD
/
YYYY
School
Your answer
Student Name
Your answer
Parent Name and Contact
Your answer
Please read the Trailblazer Oath and check the statements below showing you recognize the responsibilities of the Trailblazer:
*
Trailblazers understand road safety rules as taught in the road safety training modules (either in person or by video as circumstances allow)..
Trailblazers wear a class 2 traffic vest to increase visibility of students walking to school.
Trailblazers follow a preferred route to school, (identified on the Trailblazer map).
Trailblazers are not expected to supervise other students.
Trailblazers report problems to the school.
Required
The student must return the vest at the end of the year, or earlier if they can no longer fulfill the Trailblazer duties for the school year.
I understand my child must return the vest to the school at the end of the year.
I understand my child must return the vest to the school earlier if they can no longer be a Trailblazer.
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Please include a statement about why your child will make a great Trailblazer.
Your answer
I have read this document and I agree to help my child uphold all its terms.
Yes
No
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Thank you for your support of this important program and the leadership opportunity it brings to your child. Please let us know if you have any additional comments or suggestions here.
Your answer
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This form was created inside of WATERLOO REGION DISTRICT SCHOOL BOARD.
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