Passenger Transportation Waiver |
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Student's First and Last Name |
I, the parent / guardian of the student passenger 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: |
I understand that Falls Lake Academy does not provide transportation for students to activities and events held off-campus, nor does Falls Lake Academy, its Board, or its staff accept any responsibility for students as they are being transported by private vehicle. In allowing my child (named above) to travel by private vehicle to and/or from activities and events off campus, I do so of my own volition as an agreement with the driver of that private vehicle, 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 understand that the driver of the vehicle in which my child is riding is personally and fully responsible for the students who are riding in that personally-owned vehicle. Falls Lake Academy, Falls Lake Academy, Inc., the Board, and the staff are in no way involved in the agreement between the driver of the vehicle and myself and bear no responsibility for the safety of my child while he/she is riding with that driver in that vehicle. (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.] Name (printed) of the above-named student's parent(s)/guardian(s): |
I accept these responsibilities and agree to the provisions listed above, for as long as my child is enrolled at Falls Lake Academy. |
Name of parent/guardian who completed this form |
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