Walk Home Unaccompanied by Adult Permission

At St Julian’s Primary, all children from Nursery to Year 4 must be collected by an appropriate adult. Any appropriate adult must be at least 16 years of age and listed on the child’s school database. In Years 5 and 6, we would still rather children be collected by an adult, however we recognise that some parents may want or need their child to walk home unaccompanied by an adult. If that is the case, please submit this consent form to the school to enable the class teacher to release the child without an adult present at the end of the school day.

Please note that if a child needs to leave before the end of the school day (ie. for a medical appointment), they must be collected and signed out by an adult. If a child is attending an after school club or event, they must also be collected by an adult.

You can either complete the online form below or download and print a paper copy of the form and return it to the school office.

Download Paper Form

Walk Home Unaccompanied by Adult Permission Form

Fields marked with an * are required

Child's First Name *

Child's Last Name *

Child's Class *

Child's Date of Birth *

Is this a one-off request for a single occasion or regular arrangement? *

One single occasion
Regular arrangement

Date On/From *

Which days are you giving permission for your child to walk home unaccompanied by an adult??

Monday
Tuesday
Wednesday
Thursday
Friday
Any or All of the above

Reason for requesting child walks home unaccompanied by an adult *

Declaration (Tick Box) *

I, the undersigned parent/guardian of the above-named student, hereby give permission for my child to walk home from school unaccompanied by an adult. I understand and acknowledge the following:

Risk Awareness: I am aware that by allowing my child to walk home alone, there are inherent risks, including but not limited to road safety hazards, interactions with strangers, and other environmental factors.

Parental Responsibility: I accept full responsibility for my child from the moment they leave the school premises, including their safety, well-being, and decision-making while walking home.

School Liability Waiver: I acknowledge that the school and its staff are not responsible for my child’s safety once they have exited the school site.

Emergency Situations: I have discussed safety measures with my child and have ensured they are aware of safe walking routes, traffic rules, and emergency procedures.

Revocation of Consent: I understand that I may revoke this consent at any time by providing written notification to the school. I understand that if my child behaves inappropriately or dangerously on the way to or from school, the school may revoke consent to release my child without an adult present.

By signing below, I confirm that I have read, understood, and agree to the terms outlined above.

Parent's First Name *

Parent's Last Name *

Parent's Email Address *

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Walk Home Unaccompanied by Adult Permission

Walk Home Unaccompanied by Adult Permission Form

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