Walking School Bus Registration | United Way of Racine County

Register your student(s) today!

Name of Student

Grade

Infinite Campus ID

Student Homeroom Teacher

Do you have more students to register?

Yes

Name of Student

Grade

Infinite Campus ID

Student Homeroom Teacher

Do you have more students to register?

Yes

Name of Student

Grade

Infinite Campus ID

Student Homeroom Teacher

Do you have more students to register?

Yes

Please list name, grade, Infinite Campus ID and homeroom teacher of additional children

Please list any special conditions and/or allergies

Name of Parent/Guardian

Address

City

State

ZIP Code

Primary Contact Number

Secondary Contact Number

Email Address

I agree to the terms of service.

Terms and Conditions

I give permission for my child(ren) to participate in the Walking School Bus program and to be photographed for promotional purposes.
I will not hold staff, administrators, or volunteers at Racine Unified School District and United Way of Racine County responsible for accidents or injuries involving my child(ren).
I understand that routes will be scheduled based on Route Leader availability and location of other WSB participants.
I acknowledge that my student will not be walked home.

By signing this form, I understand that my child is not guaranteed to be on a route, but will be considered during route planning.

Signature

Date