Form from: Saint Maximilian Kolbe Catholic School (540-1212-SK1)

It is important that we have an accurate record for each student's transportation plan. You will be asked to complete the following questions per child.  

NOTE: Registration is required for students to attend extended day.  See separate link.

NOTE: Permission Form must be signed for students to walk or bike home from school.  See separate link.

Family Name

Student 1 - Name

Student 1 - Grade

The above student will leave school most days by:

NOTE: Office must be notified by to 2:00pm with any changes to instructions.

Student 2 - Name

Student 2 - Grade

The above student will leave school most days by:

NOTE: Office must be notified by to 2:00pm with any changes to instructions

Student 3 - Name

Student 3 - Grade

The above student will leave school most days by:

NOTE: Office must be notified by to 2:00pm with any changes to instructions

Student 4 - Name

Student 4 - Grade

The above student will leave school most days by:

NOTE: Office must be notified by to 2:00pm with any changes to instructions

Student 5 - Name

Student 5 - Grade

The above student will leave school most days by:

NOTE: Office must be notified by to 2:00pm with any changes to instructions

List ALL additional adults (not parents/guardians) you authorize to pick up your child(ren). Note: if these adults are unknown to school staff, they will be asked to show their drivers liscense

List the adults you DO NOT authorize to pick up your child(ren). [type N/A] if not applicable

Your name

Your email