904.1 E1 Extracurricular Contest Transportation Form

PDF OF THE EXTRACURRICULAR CONTEST TRANSPORTATION REQUEST

I request that my son/daughter be transported to and from Lewis Central Community School District for the following extracurricular event/date only: ______________________________________

If my request is granted, I understand that the granting of the request is limited to transportation to and from Lewis Central Community School District extracurricular contest on the specified date, and will automatically expire prior to additional events and activities.

I accept responsibility for and will make arrangements to provide transportation for my son/daughter to the activity and date specified above which is part of my son’s/daughter’s participation in the Lewis Central Community School District’s extracurricular activities.

If my request is granted, I will hold harmless and defend and indemnify the Lewis Central Community School District from any and all damages and/or claims that may arise out of the transportation of my son/daughter to and from extracurricular activity contests that are part of my son’s/daughter’s participation in the Lewis Central Community School District’s extracurricular activities. If any action is brought against the Lewis Central Community School District or any of it officers, employees or agents, arising out of the transportation of my son/daughter to and from extracurricular activity contests that are part of my son’s/daughter’s participation in the Lewis Central Community School District’s extracurricular activities, I will assume full responsibility for the legal defense any action, and upon my failure to do so on proper notice, I understand and agree the Lewis Central Community School District reserves the right to defend such action and to charge all costs, including attorney fees, to me.

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS DOCUMENT AND FREELY AND KNOWINGLY AGREE TO THE TERMS AND CONDITIONS SET OUT IN THIS DOCUMENT.

 

_____________________________ ________________________

Parent  Date  Parent  Date

The request made by the parties who have signed this document has been reviewed and approved subject to the terms and conditions set out above.
 

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Authorized Representative  Date

Lewis Central Community School District