Bus Waiver Form
Waiver form for the Lodge Student Ministry
Name (Parent/or Guardian)
Name of Child/Dependent
Terms and Conditions
By acknowledging this form you agree to the following terms in order to ride on the Heart O The Lakes Bus:
1. Waiver and Release: I release and forever discharge and hold harmless Heart O The Lakes and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from riding the Heart O The Lakes Bus. It is also understood Heart O The Lakes does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance in the event of injury, illness, death or property damage.
2. If a Heart O The Lakes member requires assistance from an Aide, said member shall be required to have Aide present while riding the bus at all times.
By Clicking 'Yes' I acknowledge that I am the parent/guardian of aforementioned student and I agree to the terms and conditions and hold Heart O The Lakes harmless.
I do not agree
Connecting Students with Hope for a Better Monday
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