The Copley Kids Program

(Permission to Ride the Bus)

Name of Student: ___________________________________________________ Date:__________________

                                                                        (PLEASE PRINT)

              I/We give permission for our/my child to ride the bus from the Magnolia Middle School to the

Copley Kids Program at the Church of the Resurrection, Bridge and Anchor Drives, in Joppatowne, Maryland.

 I understand that any misbehavior will subject the above named youth to dismissal of ride privileges and program participation by either MMS staff or Copley Kids Program staff.

Parent/Guardian: ___________________________________________________ Date____________________

Telephone No. Home _______________________________ Cell/Emerg:________________________________