Holbrook Unified School District #3

School to Home Supervision Transportation Consent Form

Parents/Guardians:

The Holbrook School District makes student safety a top priority. As parents of our youngest students (K-1 students). We are reaching out to you, as our partners, to ensure our students are safe getting from home to school and school to home. We want to ensure our students have proper supervision when our bus drivers release our students from the buses. To that end, we are asking that each parent consent to the method in which our K-1 students are supervised as they return home from the bus stop. 

Please review the information below and sign the partnership agreement that identifies how your child will be supervised from the bus stop home each day. This will allow our bus drivers to supervise students at their drop off location and most importantly ensure your child arrives home safely.

• Please communicate with your child’s respective school if there are any bus stop changes before 2pm each day. If there are changes, please be sure to have an adult present to pick up your child.

• We ask that students arrive at their bus stops 5 minutes prior to the posted bus arrival time.

• Remind students to stay at their assigned bus stop in a safe area, approach the bus only after it has come to a complete stop, the door has been opened, and the driver has motioned the student to board.

• Students should enter the bus in an orderly fashion, find a seat quickly and use “indoor voices” while on the bus.

• We ask that parents and students NEVER PURSUE THE BUS IF MISSED, BUSES WILL ONLY STOP AT ASSIGNED BUS STOPS DUE TO SAFETY REASONS.

• For safety purposes, ONLY students may board the school bus; no one else will be allowed to board the bus for any reason.

• NO EATING OR DRINKING ON THE BUS-this is a high priority due to choking hazards and overall student safety.

In addition, all bus rules are posted in the buses and will be enforced by the driver. The school bus is considered an extension of the classroom; therefore, behaviors contribute to safety, please discuss this with your child. All student conduct rules apply on all school buses. Transportation to school is a privilege, not a right.

In closing, we ask that all parents/guardians who are responsible for K-1 students be present at the bus stop; as well as, are listed on the emergency contact list filed with the school. It is our procedure that a K-1 student will not be let off the bus without a parent/guardian or older sibling to accompany them home or verification that your consent for the student to walk home by themselves. In the case that there is no one to accompany the child and a consent form is not on file, your child will remain on the bus and WILL BE BROUGHT BACK TO THE SCHOOL and you will be contacted to meet your child at the school.

Please review, sign and return this form to your child’s school by ___________. We will follow up with a phone call for those students that do not return this form.

Name of Child: __________________________ Grade: _____ Bus Route: ___________

Parent or Guardian’s who will be at the bus stop to pick up the K-1 student:

Print Name(s): ________________________________________________________________

Sibling(s) who will accompany student home from the bus stop:

Print Name(s): ________________________________________________________________

My student is allowed to walk home alone from the bus stop.

Print Parent/Guardian Name: _______________________________ Date: __________

Signature of Parent/Guardian: _______________________________ Date: _________

Office Use: Received Date: ______________ Bus Route: __________ 

Received By: __________________________