Driver Transportation Waiver

Email

Student's Grade

Student's First and Last Name

Student ID

I, the licensed driver named above, understand and agree to be bound by the following, as indicated by my initials by each one and my signature at the bottom of this form:

Driver's Full Name

I understand that Falls Lake Academy does not provide transportation for students to activities and events held off-campus, and that those licensed drivers who choose to transport students to and/or from activities and events off-campus do so of their own volition as an agreement with the parents of those students whom I transport, with no expectation of responsibility or liability on the part of Falls Lake Academy, Falls Lake Academy Inc., or its Board or staff members. (initial below)

I certify and attest that I hold a valid operator’s license and agree to keep it current for the duration of the period during which I will be transporting Falls Lake Academy students in a personally-owned vehicle. (initial below)

I certify and attest that I am fully covered by a driver’s liability insurance policy and agree to keep that policy current for the duration of the period during which I will be transporting Falls Lake Academy students in a personally-owned vehicle.

(initial below)

I understand that I am personally and fully responsible for the students who are riding in a personally-owned vehicle while I am driving that vehicle, and I accept that full responsibility and agree that my own insurance covers any eventuality with respect to accidents and/or injuries while riding in that vehicle when I am driving. (initial below)

I waive all responsibility and do indemnify and hold harmless Falls Lake Academy, Falls Lake Academy Inc., its Board, and its staff members, from any and all litigation that may arise following an accident or other event, and from all consequences arising from such litigation. (initial below)

I accept these responsibilities and agree to the provisions listed above, for as long as my child is enrolled at Falls Lake Academy. By printing your name below it is legal equivalent of your manual signature on this Agreement.

I accept these responsibilities and agree to the provisions listed above, for as long as my child is enrolled at Falls Lake Academy.

Today's Date