WALK AND ROLL PERMISSION SLIP

WALK AND ROLL PERMISSION SLIP

YOU MAY INCLUDE ALL YOUR FAMILY'S PARTICIPATING STUDENTS IN THIS SINGLE FORM. PLEASE SUBMIT THIS FORM NO LATER THAN May 1, 2026.
Student Name(s)
Parent Participation
Departure Point: My child will begin the walk/ride from:
If you chose 'Other' above, please describe.
I understand that if my son/daughter becomes ill or is injured during this trip, someone will attempt to contact me or an emergency contact at the numbers listed below:
PARENT'S NAME:

First NameLast Name
PARENT'S PHONE NUMBER:
Please enter a valid phone number.Format: (000) 000-0000.
EMERGENCY CONTACT:

First NameLast Name
EMERGENCY CONTACT PHONE NUMBER:
Please enter a valid phone number.Format: (000) 000-0000.
As parent/guardian of student(s) listed above, my child has my permission to walk, bicycle or roll to school on May 6, 2026 for the Walk and Roll to School Day event.

If I cannot be reached, I understand and agree that my son/daughter may be taken for medical assistance, and I agree that I will be solely responsible for any and all costs incurred as a result. I further agree to indemnify and hold harmless Beaverton Schools, the district, its board members, its employees and any volunteer for this event for any injury that occurs to my child which is not the result of action or inaction by the district or its representatives. By entering my electronic signature and the date below, I signify that I agree to these terms.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: