Parking/Carpool Information Form

ALL FAMILIES: please complete all sections of the form below by August 1, 2022.

Parking assignments are based on the youngest child in the family. PLEASE park in your assigned lot only.

The safest and only authorized dismissal route for non-walker students is from one of the STCS parking lots.

•Families with a kindergartner or a 1st grader will be categorically assigned to the elementary school side for safety.

•In general, elementary families will be assigned to the elementary side, middle school families to the middle school side, and families with an 8th grader (but no kindergartner nor 1st grader) to the church lot. However, this will not be the case for all families.

•Only walkers will be allowed to cross the property line onto Ice Pond Road. A walker is defined as a student who can walk to their home without having to cross Ashburn Farm Parkway, Claiborne Parkway, or Broadlands Boulevard.

•If a non-walker attempts to leave the property on foot, a staff member may direct the child back to the school office. This is to avoid panicked children attempting to find parents who are late / not in the lot. Staff will follow the standard procedure of having the child sign in at the office to wait for parent pick-up.

•Students should not walk through neighbors' property to the cul de sac in the Ashburn Run neighborhood. Students should not walk down the STCS driveway to Broadlands Boulevard to be picked up.

•St. Theresa Catholic School will accept no liability or responsibility for any non-walker children who leave school property in any way other than in a vehicle from the parking lot.

The school playground is temporarily closed DURING dismissal for safety. Families are welcome to wait on the sidewalk and return to the playground once all the cars have emptied from the lot.

Student's Last Name: *

Parent's Last Name: *

Primary Email Address: *

Childs First Name *

Childs Last Name *

Grade 2022-2023: *

Childs First Name

Childs Last Name

Grade 2022-2023:

Childs First Name

Childs Last Name

Grade 2022-2023:

Childs First Name

Childs Last Name

Grade 2022-2023:

Street Address

Address Line 2

City

State

Zip Code

Primary Phone Number

Grades for the 2022-2023 school year for my children: *

K	1
2	3
4	5
6	7
8

Check all that apply (example: if you carpool and also use after school care then you would check both boxes).

If you would like to find someone to carpool with, please email the school office (schooloffice@stsashburn.com) with the following information: your name, where you live, the number of children you have, and the best way to contact you. Your request will be included in the Thursday Thunder newsletter.

What is your parking/carpool status? (See Definitions Below): *

Carpool As Needed (Complete the Carpool section below)

Carpool Part-Time (Complete the Carpool section below)

Carpool Full-Time (Complete the Carpool section below)

Do Not Carpool

Walker

After-School Care (Complete the After-School Care section below)

Definition of Parking Status

Carpool - I carpool with another family. Please enter the carpool information below.

Do Not Carpool - I do not carpool with another family, but will be picking up my child from school.

Walker - My child is a WALKER and needs a walker badge. A walker is defined as a student who can walk to their home without having to cross Ashburn Farm Parkway, Broadlands Boulevard, or Claiborne Parkway.

After-School Care - My child will be attending after-school care either at the STCS Extended Day Care or transported by van/bus to another after-school facility. Please enter the information below for the program that your child will be going to.

Carpool Information

If you will be carpooling with another family, please enter the last name of the family in your carpool and the grades of their children. If you are carpooling with more than one family, you may enter both names in the same field.

Carpool Family Name:

Grades of Carpool Family's Children:

After-School Care Information

I will use St. Theresa Catholic School Extended Day Care *

Yes

No

If your child will be attending an Off-Site After-School Care program, please provide the following information.

Off-site After-Care Provider Name:

Provider Telephone Number: