* Required

Student First Namerequired

Student Last Namerequired

Student Graderequired

Student IDrequired

Primary Car Makerequired

If Car Make is Other, Please enter Make

Primary Car Modelrequired

Primary Car Colorrequired

Primary Car Yearrequired

Primary Car License Plate Numberrequired

Would you like to register a secondary car?*

Yes No

Secondary Car Makerequired

If Car Make is Other, Please enter Car Make

Secondary Car Modelrequired

Secondary Car Colorrequired

Secondary Car Yearrequired

Secondary Car License Plate Numberrequired

Parental Permission To Drive To And From School

Parent/Guardian Checkbox*

By checking the Parent/Guardian Checkbox above, I am acknowledging electronically that I am the parent or legal guardian of the above named student, granting permission for my student to register the above listed vehicle with DCDS Safety and Security at the upper school campus.

I understand that this vehicle must be operated responsibly; otherwise, I shall cooperate fully with whatever action is taken by Detroit Country Day School.

I further understand that no liability will be assessed against Detroit Country Day School with respect to my son's/daughter's operation of this automobile.

My Son/Daughter and I have read and discussed the section regarding Detroit Country Day School driving policy located under the Junior and Senior Privileges Section of the Student Parent Handbook available on both the Student Portal and the Parent Portal. We both understand that the privilege to use this car daily is subject to compliance with Detroit Country Day policy, and that any non-compliance with these rules may result in revocation of driving permission.

Fees

On or Before September 30 of the current school year $20.00

Fee Checkbox*

Fee Amountrequired

By checking the Fee Checkbox above, I am acknowledging electronically that the appropriate fee will be charged to the above named student account.

Parent/Guardian Signaturerequired

Daterequired (mm/dd/yyyy)

Please send a confirmation email to the address below*:

Please provide an email address where we can send a link to your current form.

Email Address :