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Irmo Middle School Walk To School Day Permission Form LETS GET WALKING!!

Please return this form to your childs 4th block teacher by Monday , Oct. 7 in order for your child to participate.

I, ______________________________________, give permission for Parent/Caregivers Name ___________________________________ to participate in Walk to School Day Childs Name with [school name] on [date]. ( ( ) I will be walking with my child to school on this day ) A family member will be walking with my child to school on this day

( ) I will not be walking with my child to school on this day, but will bring him/her to the designated meeting location

_________________________________________________ Parent Name _________________________________________________ Parent Signature