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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1. Student Name: *
2. Physical Address: *
3. School *
4. What grade is your student currently enrolled in? *
5. Which of the following best describes your student:
6. How does your student currently commute to school? *
7. How will your student participate in the Walking School Bus?
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8. Would your student be walking with the: *
9. Parent or Guardian Name: *
10. Parent or Guardian Email Address: *
11. Parent or Guardian phone number: *
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.
13. How would you like to receive updates and communications from the Walking School Bus Leader? *
14. Does your student have any allergies or injuries that we need to know about?:
15. Are you interested in volunteering with the Walking School Bus program? *
16. Are you interested in the PAID Walking School Bus Leader opportunity? Job Description -- Application *
17. How did you hear about the Walking School Bus?
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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.             *
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