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Walking School Bus Registration Form
Sign up your student to walk or roll to school with our Walking School Bus! Complete one form per student.
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to save your progress.
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* Indicates required question
1. Student Name:
*
Your answer
2. Physical Address:
*
Your answer
3. School
*
Your answer
4.
What grade is your student currently enrolled in?
*
P-K
K
1st
2nd
3rd
4th
5th
5. Which of the following best describes your student:
*
Asian or Pacific Islander
Black or African American
Hispanic or Latino
Native American or Alaskan Native
White or Caucasian
Multiracial or Biracial
A race/ethnicity not listed here
Prefer not to answer
6.
How does your student currently commute to school?
*
Dropped off by family vehicle
Carpool with other students
School Bus
Public Transit/Cascade East Transit Bus
Walk
Roll - Bike, Skateboard, Scooter, etc.
Other:
7.
How will your student participate in the Walking School Bus?
Walk
Roll - bike, scooter, skateboard, etc
Clear selection
9.
Parent or Guardian Name:
*
Your answer
10.
Parent or Guardian Email Address:
*
Your answer
11.
Parent or Guardian phone number:
*
Your answer
12.
List all adults (name/phone number) who are authorized to pick up your student. Only the people listed will be allowed to pick up your student from the Walking School Bus.
Your answer
13. How would you like to receive updates and communications from the Walking School Bus Leader?
*
Email
Text message
Phone call
GroupMe App (keeps contact information private)
14.
Does your student have any allergies or injuries that we need to know about?:
Your answer
15.
Are you interested in volunteering with the Walking School Bus program?
*
Yes
No
Maybe, send me more information
16. Are you interested in the PAID Walking School Bus Leader opportunity?
Job Description
--
Application
*
Yes
No
Maybe, send me more information
17.
How did you hear about the Walking School Bus?
School’s Social Media
Word-of-Mouth
Commute Options Social Media
Event
Other
Clear selection
PERMISSION SLIP REQUIRED
Download here:
bit.ly/3SVtzm7
I understand a signed permission slip is required for my student to participate in the Walking School Bus. I will provide a signed copy to
whitney@commuteoptions.org
before my student joins the Walking School Bus. Contact us directly if you need a paper copy.
*
YES
Submit
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