West Zephyrhills Elementary Bike/Walker Authorization Form 2026-2027

At the beginning of the 2026–2027 school year, we want to share safety procedures for students who are authorized to walk home at dismissal. A "walker" is defined as a student who walks directly to and from home and does not ride a school bus or leave campus in a vehicle. Parents or guardians who transport students by car must use the designated car line for dismissal.

If your child is designated as a walker or bike rider, please review the following procedures:
• Bus Riders/Walker students will be released to walk/ rider their bikes home according to their authorized dismissal plan.
• Students will not be released directly to an adult at the walker dismissal area.
• The walker/bike rider dismissal area is not a parent pick-up location.
• Adults picking up students by vehicle must use the car line.
• If a student refuses to leave campus as a walker/bike rider or is unwilling to be released, the student will be escorted to the front office.
• An authorized adult may pick up the student after 4:30 p.m. a valid government-issued photo ID is required.

This authorization form helps the school maintain accurate dismissal records and confirms that students have permission to walk/bike to the authorized destination.

Inclement Weather Procedures:
For the safety and security of our students, walker/bike rider dismissal may be suspended during periods of inclement weather. In these situations, walker/bike rider students will remain safely supervised in the front office until dismissal can safely resume or until the student is released to an authorized adult.

All adults picking up a student must:
• Present a valid government-issued photo ID; and
• Be listed as an authorized contact in PascoOne.

We appreciate your patience, cooperation, and partnership as we work together to provide a safe dismissal process for all students.

Student's Name / Nombre del estudiante Student's Name / Nombre del estudiante First Last
For the safety and security of our students, if there is inclement weather, students will remain in the front office until they can be released to an authorized adult. All adults picking up students must be verified through the information provided in PascoOne. We appreciate your patience and cooperation during these situations.

En caso de condiciones climáticas adversas, los estudiantes permanecerán en la oficina principal para su salida. Por seguridad, solo serán entregados a un adulto autorizado cuya identidad pueda ser verificada mediante la información registrada en PascoOne. Gracias por su comprensión y colaboración.
Teacher's Name / Nombre del Profesor
Parent's Name / Nombre del Padre o de la Madre Parent's Name / Nombre del Padre o de la Madre First Last
Phone Number / Número de teléfono Phone Number / Número de teléfono - ### - ### ####
I acknowledge that my child will be released to walk independently. I understand school staff will not directly release my child to an adult.

Reconozco que se permitirá a mi hijo marcharse caminando por su cuenta. Entiendo que el personal de la escuela no entregará a mi hijo directamente a un adulto.

I acknowledge that my child will be released to walk independently. I understand school staff will not directly release my child to an adult. Reconozco que se permitirá a mi hijo marcharse caminando por su cuenta. Entiendo que el personal de la escuela no entregará a mi hijo directamente a un adulto. Yes
Draw or type your signature into the box below.

Dibuja o escribe tu firma en el recuadro de abajo.

Draw or Type

I understand this is a legal representation of my signature.

Entiendo que esta es una representación legal de mi firma. Clear

Full Name

I understand this is a legal representation of my signature.

Entiendo que esta es una representación legal de mi firma.