ParentStudentHandbook2017-18 AUG.17

Travel Liability Form *Please read thoroughly before signing*

All students who ride the District designated transportation for athletic events are generally expected to return home via the same mode of transportation. However, parents or designee set forth below who follow the bus may desire for a child to return home with them in a private vehicle.

If a parent desires to provide transportation for his/her child back home in a private vehicle, please note the following:

▪ Once the parent allows for the removal of his/her child from the District sponsored bus, Berlin Borough School District is no longer responsible for the student's supervision.

▪ Once the parent allows for the removal of his/her child from the District sponsored bus, the parent assumes full responsibility for the child's supervision.

▪ Once the student is no longer the responsibility of Berlin Borough School District personnel, the person operating the privately owned automobile assumes all responsibility for the transportation of the student.

Please complete the following:

Student's Name:

Grade:

Teacher:

Event:

Date of Event:

Please print the name of the adult who you give permission to transport your child home

Signature of the adult who is taking the child home

Date

I have carefully read this Travel Liability Form and acknowledge that I understand it. My child will return with his/her parent or designee. I understand once I agree to remove my child from the District sponsored bus, I am assuming all responsibility for my child's supervision and transportation. I understand this form supersedes any verbal or previous written request in regards to my child's mode of transportation.

Parent/Guardian Name (Please Print)

Date

___________________________________________________ Parent/Guardian Signature

Please remember, each form is only good for one date! THIS FORM CANNOT BE USED FOR FIELD TRIPS!

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