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Bike Rider/Walker Consent Form

optional form - 1 per family

This form provides the school with information regarding which students are allowed, with permission from their parent or guardian, to ride their bike or walk to school and back home at the end of the school day. Walking and bike-riding students will be dismissed after all vehicles have left the parking lot.

Please check the days of the week you give permission to your child(ren) to ride his/her bike or walk home:*
Answer Required
Please check if you give your child(ren) permission to ride his/her bike or walk home on Early Dismissal and/or Regular Dismissal Days*
Answer Required

Please list the name(s) below of all students who have permission to walk/ride:

By signing this form, I understand that the school is responsible for my child until they are dismissed. Once my child has been released, it is at my own risk that my child is no longer supervised, and St. Clement of Rome Catholic School and the Archdiocese of St. Louis are not liable.

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By pressing “Sign Form,” you are agreeing to signing this form electronically.
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Thank you for your cooperation while we are doing all we can to keep your child(ren) safe.

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