Carpool Sign-Up Form - Creative Montessori Academy

 

 

Carpool   S ign   U p   F orm  

 

If   y ou   a re   i nterested   i n   c arpooling   p lease   c omplete   t he   f orm   b elow   a nd   r eturn   i t   t o   M s.   C arrie   i n   t he  

Main   O ffice.  

 

Parent/Guardian   ( print   f ull   n ame):   _ _______________________________________________________  

 

Address:   _ ____________________________________________________________________________  

 

City:   _ ___________________________________   Z ip   C ode:   _ ___________________________________  

 

Major   C ross   S treets:   _ ___________________________________________________________________  

 

Phone   N umber:   _ _______________________________________________________________________  

 

E-­‐mail   A ddress:   _ _______________________________________________________________________  

 

Emergency   C ontact:   _ ___________________________________________________________________  

 

Address:   _ ____________________________________________________________________________  

 

City:   _ ___________________________________   Z ip   C ode:   _ ___________________________________  

 

Phone   N umber:   _ _______________________________________________________________________  

 

Child’s   F ull   N ame:   _ ________________________________   T eacher:   _ ____________________________  

 

Child’s   F ull   N ame:   _ ________________________________   T eacher:   _ ____________________________  

 

Child’s   F ull   N ame:   _ ________________________________   T eacher:   _ ____________________________  

 

 

I   w ill   b e   a vailable   t o:  

 

Drive   b efore   s chool_____                   D rive   a fter   s chool   _ ___             I   w ould   p refer   n ot   t o   d rive   _ ___  

 

I   _ __________________________________   g ive   C MA   p ermission   t o   r elease   m y   n ame   a nd   p hone    

                                  P rint   P arent   /   G uardian   N ame  

number   t o   o ther   C MA   p arents   i nterested   i n   c arpooling.   I   f urther   r ealize   t hat   a ny   s pecial   c ircumstances  

that   m ay   a rise   ( i.e.   s ick   c hild,   s now   d ays,   e arly   p ick   u ps,   e tc)   w ill   b e   h andled   b etween   m yself   a nd   t he  

other   c arpool   p arents.   C MA   w ill   n ot   b e   r esponsible   f or   c ommunication   b etween   p arents.  

 

Parent/Legal   G uardian   S ignature   _ _____________________________________