Student Walker Contract 2026-2027

Please complete this form if your child would like to walk home from school.

Student 1 Name Student 1 Name First Last
Add a second student?

Add a second student? Yes No
Student 2 Name Student 2 Name First Last
Add a third student?

Add a third student? Yes No
Student 3 Name Student 3 Name First Last
Add a fourth student?

Add a fourth student? Yes No
Student 4 Name Student 4 Name First Last
Location/Address to which the student(s) will be walking: Location/Address to which the student(s) will be walking:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Approximate distance the student(s) will be walking is:
Walker Release Statement
I, the parent/guardian of the above named student(s), do hereby request that my child be classified and granted "walker status".
Parent/Guardian Name Parent/Guardian Name Title First Middle Last Suffix
Parent/Guardian Email
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.