School Pick-Up & Transportation Permission Form
Provide permission and contact details for Wednesday/Friday school transportation.
Gentleman's Name
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First Name
Last Name
School
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Grade
*
Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Permission to Transport Acknowledgment
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I give permission for my child to be picked up from school on Wednesdays and Fridays by an authorized Men 2 Be, Inc. mentor/staff member to participate in Men 2 Be programming.
Parent/Guardian Responsibilities Acknowledgments
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If my child will NOT be riding on a scheduled pick-up day, I will notify Men 2 Be no later than 12:00 PM that day.
I will make sure my child knows in advance that he is riding with Men 2 Be.
My child must report to the school’s designated car rider/pick-up area immediately after dismissal and be ready when the Men 2 Be mentor arrives.
I understand that mentors cannot search throughout the school for students who are not at the designated pick-up area.
I will keep Men 2 Be informed of any changes that may affect transportation.
Authorization Statement
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I authorize Men 2 Be, Inc. mentors/staff to transport my child from school on Wednesdays and Fridays as described above.
Parent/Guardian Signature
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Date (Parent/Guardian Signature)
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gentleman's Signature
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Date (Gentleman's Signature)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: