This document affects your legal rights.  You should read it carefully before signing.  

I understand and acknowledge that I am the legal parent or guardian of (child’s name listed below) and by signing this document, I am releasing and agreeing not to sue, for myself, and my minor children, and my agents, heirs, executors, administrators, and assigns (collectively, “Releasors”) Keene Housing Kids Collaborative its directors, officers, and employees, their successors, assigns, estate, and heirs (collectively, “Releasees”), from any and all liability, claims, debts, demands, rights, actions, causes of action, whether known or unknown, at law or in equity, which I ever had, now have, or in the future may have against Releasees relating to or in connection with my participation (or that of my minor children) in the use of transportation services arranged by Keene Housing Kids Collaborative.

I understand that Keene Housing Kids Collaborative’s role is to arrange transportation with Thomas Transportation so my minor child(ren) may attend activities and events in the community.  Keene Housing Kids Collaborative does not employ the drivers or maintain vehicles.

I agree to accompany my minor child(ren) at all times or designate another adult (listed below) who will accompany my minor child(ren) at all times during transportation arranged by Keene Housing Kids Collaborative.  I, or the person designated below, shall be responsible for the care of my child(ren) at all times during transportation. 

I understand that riding in a motor vehicle is potentially dangerous.  I assume the risk of personal injury to myself and my child(ren) and/or property damage.

I will make sure my minor child(ren) will use appropriate safety restraints such as a seatbelt, car seat, booster seat.  If my child(ren) requires a car seat or booster seat, I will provide it and install or have the person designated herein install such car seat or booster seats.  I will also wear a seatbelt while using transportation arranged by Keene Housing Kids Collaborative.  If I have designated another adult to accompany my child(ren) I will make sure that adult follows these safety protocols. 

I agree to these terms because Keene Housing Kids Collaborative arranged transportation for me and my minor child(ren) and that the transportation service is a valuable service enabling my child(ren) to participate in extracurricular activities.

I freely agree to the terms of this Release.  With this Release, I intend to bind myself (and my minor children, if any) and my agents, heirs, executors, administrators, and assigns.

I acknowledge that this release is a contract with legal consequences and not a mere recital, that I have been advised to read it carefully before agreeing.

I agree to cancel any scheduled rides no later than 24 hours before the scheduled time of pick up. If I do this three times, KHKC has the right to cancel my service.

I understand that the driver will knock on my door upon arrival. If no answer, the driver will call my contact number. The driver will wait for 5 minutes and if I am not there, the driver will leave. If the driver leaves without providing my ride three times, KHKC has the right to cancel my service.