Independent Traveller Form

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If your child comes to school or goes home without an accompanying adult, you must complete the attached form and return it to the school office as soon as possible. If an older school-aged sibling is responsible for ensuring your child arrives in school, you must still complete this form. Please ensure your child does not arrive before 8:40 am as the school cannot accept legal responsibility for children at this time.

If your child is not attending school (due to illness for example) please contact the school before 9:00 am to advise us of this. Failure to do so will result in the school contacting you at home and at work to verify the whereabouts of your child. If we are unable to contact you we will refer the matter to the local Police. This is to ensure the safety of your child.

If you child leaves school independently, even to walk up to the school gates to be met by a parent/carer/older sibling, you must complete and sign the relevant section of this form.

First Name of Child *

Surname of Child *

Class *

Journey TO School - Please tick appropriate box *

My child is not an Independent Traveller and comes to school with an adult

My child is an Independent Traveller and comes to school alone, or with a school-aged sibling. I agree to contact the school by 9.00am if my child is not attending school

Journey FROM School - Please tick appropriate box *

My child is not an Independent Traveller and leaves school with an adult

My child is an Independent Traveller and leaves school alone, or a with a school-aged sibling

PARENT CONTACT DETAILS IN CASE OF EMERGENCY

Name of Parent *

Home Phone Number

Mobile Telephone Number *

If my child fails to attend school and I have not contacted the school I understand that the school will make every attempt to contact me to confirm the whereabouts of my child. I understand that the school may contact the Police if they are unable to contact a responsible adult.

Signature of Parent: (please enter your name) *

Date *

YYYY

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