KTES Walker/Biker Wavier Form

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All students who would like to walk home from school must have a waiver on file. Please submit one form per child prior to August 27, 2020. Once your child's waiver is complete, he/she will be issued a 2020-2021 walker/biker tag.

In the event of inclement weather we communicate with families of walkers/bike riders. Once you have been contacted, your child must use the alternate mode of transportation chosen on this walker/biker waiver form and noted on the back of the child's walker tag.

Please note: **Kindergarten students are not allowed to walk or bike home alone.**

Student Name (Last, First) *

Homeroom Teacher *

Grade Level *

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Please list the address where the student will be walking/biking to in the afternoon. *

Walker/Biker Release Options

Walk alone

Walk with a sibling

Walk with a parent

Biking Alone

Biking with a sibling

Biking with a parent

Please check which statement will apply to your child for the 2020-2021 school year. *

I will meet my child on school grounds to walk/bike with them. I understand that I am required to show a RED tag to a staff member before my child will be allowed to leave school grounds. (Pick up tags are available from your child’s teacher or in the front office.). You will be given a specific tag for each child.

My child will walk/bike with an older sibling or older neighbor to and/or from school. I understand an KTES staff member will ensure students are released as a group but will not require a parent or guardian to be present before leaving school grounds. Should the sibling or neighbor be absent or involved in a club, I will provide a parent note with alternate directions. You will be given a specific tag for each child.

My child is allowed to walk/bike alone to and/or from school. Students will be released immediately with or without an adult or guardian present. You will be given a specific tag.

Other:

If your child will be walking/biking with a sibling, please list the sibling's name below. *

Please select your child’s alternative transportation in the event of inclement weather. *

Car Rider

Bus Rider

Continue to walk or bike

Parent Signature as the parent/guardian, I recognize that the school’s responsibility for the safety of my child does not extend beyond school supervised areas during the walk/ride home. Signing below indicates that I understand the walker procedures and chosen an alternative transportation in the event of inclement weather. Children and families are asked to refrain from playing outside the school after dismissal - children are asked to go directly home. To ensure student safety, car riders must follow our car rider procedures. *Should a change need to be made to this form, please complete a new form or get a paper copy from our front office.* *

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