Welcome to Walnut Grove Christian School!

Student Driver Permission Form

Approval valid for the current School Year only.

If you have a student or are a student who is planning to drive to school this year, you will need to submit the form below.

Only students with signed permission slips on file will have the privilege of having a spot and parking on the WGCS campus. Even if your student drove to school last year, they MUST submit a new form for this school year.

Student Information

Student's Name(Required)

First Last

Student's Grade(Required)

Driver's License Number(Required)

State Issued By(Required)

Insurance Company(Required)

Policy Number(Required)

Parent's Name(Required)

First Last

Vehhicle Information

Make(Required)

Model(Required)

Color(Required)

Year(Required)

Vehicle License Plate Number(Required)

You must read the following statements and sign stating that you are in agreement:(Required)

Any student who possesses a valid driver’s license may drive to school. However, permission MUST be obtained from the school office before the student may drive to school.

Any student who demonstrates careless or reckless driving habits will forfeit the privilege of driving to school.

Student drivers must park their vehicles in their assigned student parking spot and may not return to their vehicles during the school day.

Under no circumstances are students to transport anyone other than those assigned by parents to ride with the student driver.

**Student Drivers with excessive tardiness or any observed reckless driving will be referred to the Headmaster and may be required to forfeit the privilege of driving to school**

Student Signature(Required)

Entering your name and submitting this form is the same as if you had signed in ink according to the ESIGN Act of 2000. Your computer's IP address and today's date will also be captured with this form submmission.

Parent Signature(Required)

I grant permission for my son/daughter to drive to official athletic contests, practices, or social events off campus during the school year, and will not hold Walnut Grove Christian School liable in case of accident or injury.

Yes

Please select all that apply:

I give my child permission to have student passengers in his/her vehicle.

I give my child permission to be a passenger in other students' vehicles.

If there are any students that you DO NOT want to be a passenger in your son's/daughter's vehicle, please list them below.

If there are any students that you DO NOT want your son/daughter to be a passenger with, please list them below.

Off Campus Student Driver/Passenger Authorization Parent Signature(Required)