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Bike Rider/Walker Consent Form

optional form - 1 per family

This form grants permission for your child(ren) to walk, bike, or scooter to and from school.  Walking or riding students will be dismissed at the same time as the rest of the student body. To ensure their safety, vehicle traffic in the parking lot will be held until all walking and riding students have cleared the area and are heading home. If your children are riding bikes or scooters, please ensure that they are wearing helmets and inform them that they must walk their bikes or scooters while on school property.

Please check the days of the week you give permission to your child(ren) to ride his/her bike or walk home:*
Answer required for "Please check the days of the week you give permission to your child(ren) to ride his/her bike or walk home:"
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 for "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"

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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Thank you for your cooperation while we are doing all we can to keep your child(ren) safe.

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