Transportation Release Form
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1Hillsboro School District Form
Transportation Release Form
School-Sponsored Activity (Alternate Adult Driver)
School ______________________ Activity/Sports Season
Name
Grade
Teacher
Address
Parent Names
Parent Contact Numbers:
(Home) _______________________ (Work) __________________ (Cell) _________________
Name of Alternate Adult Driver
and Contact Numbers: _______________________________
(Home) _______________________ (Work) __________________ (Cell) _________________
Name of Alternate Adult Driver and Contact Numbers: _______________________________
(Home) _______________________ (Work) __________________ (Cell) _________________
Name of Alternate Adult Driver and Contact Numbers: _______________________________
(Home) _______________________ (Work) __________________ (Cell) _________________
Name of Alternate Adult Driver and Contact Numbers: _______________________________
(Home) _______________________ (Work) __________________ (Cell) _________________
Check the section
which applies.
SPORTS:
My son/daughter has permission to ride with the adult driver specified to all athletic
practices and games.
ACTIVITIES :
My son/daughter has permission to ride with the adult driver specified to off -campus
contests and events associated with their activity.
Yes , I give my permission.
Parent or Guardian Initials
In consideration of the participation of my child in the above activity, I waive and release any and all rights
and claims for losses and damages that I may have against Hillsboro School District 1J arising in any way
from my child’s participation except for the sole negligence of the Hillsboro School District 1J.
•
The vehicle owner’s insurance is primary in the event of an accident.
•
The owner of the vehicle shall maintain liability insurance equal to or exceeding the state minim
requirements for liability insurance.
•
The owner of the vehicle is responsible for injury to any passengers because of accident.
In the event that my child may require emergency medical treatment while participating in the above
activity, I hereby authorize my child to receive all necessary emergency medical treatment as may be
necessary, under the existing circumstances. Unless otherwise noted, the closest available ambulance
service and hospital will be used.
Parent/Guardian Signature:
___________________ Date: ___________
□ School
□ Parent/Guardian
AA009 Transportation Release Form School-Sponsored Activity (Alternate Adult Driver) Rev. 02/23/2010
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