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Kiss and Ride Sign Up Form for 2021-2022
Please complete this form ONLY if your student will be a parent pick up at least 3 days every week. If you have multiple students, please fill in their information accordingly.
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* Indicates required question
Student Name #1 - LAST name, FIRST name
*
Your answer
Teacher Name
*
Your answer
Grade Level
*
Choose
Preschool
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Student Name #2 - LAST name, FIRST name
Your answer
Teacher Name
Your answer
Grade Level
Choose
Preschool
Kindergarten
First Grade
Second Grade
Third Grade
Student Name #3 - LAST name, FIRST name
Your answer
Teacher Name
Your answer
Grade Level
Choose
Preschool
Kindergarten
First Grade
Second Grade
Third Grade
Will your student be picked up every day?
*
Yes
No
If not, what days will your student be picked up?
Your answer
Please list the first and last name(s) of anyone authorized to pick up your student along with the color and make of their vehicle (Ex. Jane Doe, blue, Honda)
*
Your answer
Does your student have custody papers on file?
*
Yes
No
If so, please list the person and the days they are scheduled to pick up your student.
Your answer
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