Alternate Transportation Form

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Alternate Transportation Form | EISENHOWER

This form must be completed by any PARENT/GUARDIAN who wishes for their child to have ability to use alternative transportation to and from a school-related event. Families will be required to notify the staff member if/when a student will be using alternative transportation. Please put parent/guardian email below.

Email *

Name of Parent/Guardian *

Date of Travel *

YYYY

Transporting *

To the Contest/Event

From the Contest/Event

Both

Student Name *

Choose Activity
*

The person responsible for transporting the student:
*

Student transporting themself

Parent/guardian

Adult other than the parent/guardian (***must be at least 18 years old)

If other than student, name of person transporting student:

I/we choose to reserve the right to not use school-provided transportation. On behalf of myself, my heirs and executors, I/we hereby release and discharge and covenant not to sue The School District of New Berlin, its agents, officers and employees, from and for any and all liability for all loss or damages, and any claims or demands therefore, on account of injury to my child/children or property, including death, arising from transportation or any physical exercise, class, agree to indemnify and hold the School District of New Berlin and its agents harmless from any loss, liability, damage, or cost including reasonable attorney fees that may occur as a result of or resulting from my child’s participation at or use of the equipment and/or facilities; except where such loss, liability, damage, or cost results from the sole negligence of the School District of New Berlin, its agents or employees. It is understood and agreed that our vehicle’s automobile insurance will be primary and noncontributory.
*

Yes

I have read, understood, and voluntarily accepted the conditions of this permission slip/waiver of liability/release above:
*

Yes

A copy of your responses will be emailed to the address you provided.

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