Salford Hills Car Rider Information

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Please complete the below information if you choose to pick up your child(ren) as a daily car rider. A car rider once or twice can be handled with a simple note to the office on the morning of the change.
Upon completing this information, you will receive a school-issued, laminated name placard for each person listed. The name placard must be placed on the passenger side dashboard, so it is visible through the front windshield of your vehicle. Children will only be allowed to leave in vehicles with school-issued name tags. If you do not have the placard, you will be asked to pull forward to physically sign out your child.

Email *

DIRECTIONS: Add Student Information

Last Name, First Name and Homeroom

Child #1: Last Name, First Name, Homeroom *

Child #2: Last Name, First Name, Homeroom

Child #3: Last Name, First Name, Homeroom

Child #4: Last Name, First Name, Homeroom

DIRECTIONS: List Individuals Allowed to Pick Up

Last Name, First Name, and Relationship

Pickup Person #1: Last Name, First Name, Relationship *

Pickup Person #2: Last Name, First Name, Relationship

Pickup Person #3: Last Name, First Name, Relationship

Pickup Person #4: Last Name, First Name, Relationship

Pickup Person #5: Last Name, First Name, Relationship

Pickup Person #6: Last Name, First Name, Relationship

Pickup Person #7: Last Name, First Name, Relationship

Your Name and Contact Number

A copy of your responses will be emailed to the address you provided.

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