MS Pedestrian/Bicycle Permission form

PEDESTRIAN AND BICYCLE PERMISSION FORM

I give permission for my child, whose name is noted below (“Child”), to walk and/or bike (please circle one or both), independently of an adult, to Saint Mary School Ridgefield, Inc. (“School”) from home and from home to School. I have explained to my Child the safety aspects of walking and/or biking on his or her own, including but not limited to what side of the street to walk/bike, and how to cross a street. This form gives permission only to regular bicycles and does not apply to electronic motorized devices, such as e-bikes, scooters, hoverboards, or any other motorized or battery-assisted devices, which are strictly prohibited.

I understand that by granting this permission, the School is authorized to release my Child from School on his or her own recognizance at the times when I designate that he/she will walk or bike home. I also understand that my Child must leave School property at dismissal time and will not be allowed to remain on School grounds unless he or she is registered for an after-school program and has checked in with the supervising adult(s) for that specific after-school activity.

I further agree that if my plans change and my Child needs to follow a different school dismissal arrangement, I will contact the School office with written instructions for my Child. I understand and acknowledge that the School does not and cannot ensure my Child’s safety outside
of School property.

In consideration for the permission, obligations, and covenants outlined herein, the School hereby consents to allowing the Child to walk or bike to and from School.

RELEASE

In consideration of my Child walking or biking to and/or from School, I do hereby assume full responsibility for any and all damages, injuries (including death), illness, expenses, liabilities, or losses that my Child may sustain or that may accrue, if any, in connection with or related to my Child walking or bicycling to and from School as permitted by me and memorialized in this form. I hereby voluntarily and absolutely release the School and waive all claims against School, its member, the Bridgeport Roman Catholic Diocesan Corporation, St. Mary’s Corporation, and all of their employees, agents, and representatives, individually or otherwise, harmless for any and all claims for injuries or damages.

In consideration of my Child walking or biking to and/or from School, I hereby release and covenant not to sue the School, its member, the Bridgeport Roman Catholic Diocesan Corporation, St. Mary’s Corporation, and all of their employees, agents, and representatives, from any and all claims arising out of or related to my Child’s walking or bicycling to and from School. I further understand that I am solely responsible for any possible medical expenses incurred as a result of such injuries.

INDEMNFICATION

In consideration of my Child walking or biking to and/or from School, I agree to defend, indemnify, and hold harmless the School, its member, the Bridgeport Roman Catholic Diocesan Corporation, St. Mary’s Corporation, and all of their employees, agents, and representatives in connection with any claim, demand, cause of action, lawsuit, liability, cost, or expense (including reasonable attorney’s fees and costs) made or brought against School by me, my Child, or anyone else in connection with, related to, or arising out of my Child walking or biking to and/or from School, except for School’s own negligence or misconduct.

MISCELLANEOUS

This agreement shall be the entire agreement between the parties with respect to the subject matter hereof and shall supersede all previous and contemporaneous agreements and understandings, whether oral or written. This agreement may not be modified except in a writing executed by all of the parties hereto. The provisions of this agreement shall be severable and the illegality or invalidity of any provision shall not affect the legality or validity of any other provision, and each provision found illegal or invalid shall be judicially modified in any proceeding brought to enforce such provision so as to be enforceable to the maximum extent permissible under applicable law. This Agreement shall be binding on and shall inure to the benefit of each party’s respective successors and assigns. The parties may not assign all or any portion of this Agreement without the prior written consent of the Client. This Agreement may be executed in one or more counterparts, all of which shall, taken together, constitute one and the same agreement. Copies of this Agreement which are exchanged via facsimile, email or other electronic means, and the signatures thereon, will be deemed originals for all purposes hereunder.

This agreement is valid during the 2026-2027 school year and must be renewed annually.

Our family has read and discussed the 2026–2027 Pedestrian and Bicycle Permission Form, and we agree to be in full compliance with the outlined policies and procedures.