Transportation - Permission to Release Student at Bus Stop

Transportation

Permission To Release Student at Bus Stop
Bus drivers are only authorized to release kindergarteners at their designated bus stop to a parent or pre-authorized adult, otherwise, students will be returned to their school at the end of the route. Parents may hand the bus driver written permission if their student may be released to a sibling or another adult. It is recommended that younger students be supervised by an adult when walking to and from the bus stop or school. If there are individuals who are able to receive your student other than the parent/guardian please complete the following and return to your student’s bus driver. Any adult receiving the student needs to be at the bus stop at the time school is dismissed.
Student Name:
Grade
School:
Bus Number
Stop Location
I give permission to the bus driver to release my child to any of the following
Parent/Guardian Name:
Parent/Guardian Name:
Sibling Name:
Sibling Name:
Other Relative Name:
Relationship:
Other Relative Name:
Relationship:
Daycare:
Eligible receiver for daycare:
Authorized Adult:
Authorized Adult:
Best Phone Number to contact:
Please enter a valid phone number.
Alternate Phone#:
Please enter a valid phone number.
Parent/Guardian Signature:

Clear
Date

MonthDayYear
Date
Please attach photo of child if possible to assist the driver with student identification.

Cancelof
Please bring photo ID for the driver when you are receiving student off the bus.
Should be Empty: