Release Form For Liability For Student-Athletes Being Transported By Bus

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Release of Liability for Student-Athletes Being Transported by Fulton County Schools Bus Transportation
Or
By a Parent, Legal Guardian, or By Parent/Legal Guardian Designated Driver Between School Sites, Events, Activities
During and After the School Day Effective for School Year 2011-2012
Fulton County School Bus Transportation Permission
Since your high school student will be transported by Fulton County bus transportation between school sites, events, activities
during and after the school day, please complete and sign the following form, and return it to your coach.
Signature of Parent or Legal Guardian: _______________________________Date:_____________________
Signature of Student Athlete: _______________________________________Date:_____________________
-------------------------------------------------------------------------------------------------------------------------------------------------------------
Designated Driver (if applicable): All designated drivers must be family relative over 18 years of age or a parent / legal
guardian of another student attending the school.
( S t u d e n t ’ s
N a m e )
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ h a s
m y
permission to be transported to and from school sites during the school day and/or to school-related events, activities, or
sites
after
school
hours
as
a
participant
on
the
___________________________High
School
__________________Team.
Either
I
or
my
designated
driver
(name
of
driver)
_____________________________________________ will be transporting the student to and/or from the event or
activity. Either I or my designated driver will present himself or herself to the head coach and/or assistant coach after the
event or activity has been completed in order to verify the intent to transport the above mentioned student.
I agree to hold Fulton County Board of Education harmless in the event of injury to this student, including any
property damage while the student is driving or being driven to or from a school site and/or to school-related events,
activities, or sites after school hours in a vehicle other than that provided by Fulton County Board of Education.
In addition, I agree not to assert against the Fulton County Board of Education, all current, former and future
members of the School Board of the Fulton County Board of Education, former or future employees of the Fulton County
Board of Education, and their heirs, executors, administrators, successors, and assigns, in any court of law, any claim or
claims that the student and/or parent or legal guardian had, now have, or may have in the future, whether known or
unknown, based on any injuries sustained by the student while being so transported.
I have read the above agreement, and voluntarily sign the release and waiver of liability, and further agree that
no oral representations, statements or inducements apart from the foregoing written agreement have been made.
Signature of Parent or Legal Guardian: _______________________________Date:_____________________
Signature of Student Athlete: _______________________________________Date:_ ____________________
Signature of Designated Driver:_____________________________________ Date:_____________________
--------------------------------------------------------------------------------------------------------------------------------------------------
-----
(FOR SCHOOL USE ONLY)
Received by : ___________________________________________on ________________________________
(print full name)
(print date)
Signature of receiving party: _________________________________________________
PRIOR TO PARTICIPATION IN ANY CONDITIONING, TRYOUT, PRACTICE SESSION, OR PLAY IN ANY
INTERSCHOLASTIC ATHLETIC ACTIVITY, THE STUDENT-ATHLETE MUST SUBMIT THIS FORM TO THE
COACH OF THE ACTIVITY. FAILURE TO SUBMIT THIS FORM WILL DELAY THE ELIGIBILITY OF THE
STUDENT-ATHLETE TO JOIN THE TEAM.
29

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