Have an account?

Waiver and Release to Transport Child

This form serves as an agreement for parents to authorize BSC sitters to safely transport and release their child.

Primary Guardian First Name

Last Name

Relation to Child(ren):

Primary Contact Cell

Home Address:

Please provide any door or entry codes (such as keypad codes, garage codes, or security system codes) that staff may need to access/exit your home.

Emergency Contact:

Emergency Contact Address (if different from child's primary address):

Authorized Pick-Up Persons, if necessary:

Child Name, Age and Gender:

Please list other child(ren) info, if necessary:

I give permission for my child to be transported in a motor vehicle driven by the individual identified to an event at the specified location on the date indicated. I understand that my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or other adult volunteers.

I have read, understand, and discussed with my child that:

They will be traveling in a motor vehicle driven by an adult and they are to wear their safety-belt while traveling;
They are expected to respect each other, the vehicles they ride in, and the people they travel with during the trip;
Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions or acts by riders, other drivers, or objects; and
They are to remain in their seats and not be disruptive to the drive.

I recognize that by participating in this activity, as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses.

As a condition for the transportation received, I, for myself, my child, my executors and assigns, further agree to release and forever discharge The (school district), its Board, the (school district) and their agents, officers, employees and volunteers from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation.

I have read this entire waiver and permission form, fully understand it, and agree to be legally bound by its terms.

Same-Day Booking Fee of $10 I agree to the Terms & Conditions

By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release the business, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.