APPLICATION FOR CARRIAGE OF UNACCOMPANIED MINOR

(To be completed in respect of child 7-12 years, inclusive)

DATE______

The Taranaki Regional Council and Pickering MotorsLtd (the Parties) cannot be held responsible for the unaccompanied minor before, during or after the bus journey which means that:

  • The minor will be picked up/dropped off at the specified destinations.
  • The bus will not wait and will leave as per timetable.
  • The driver will act in accordance with the stated ‘Unaccompanied Minor’ policy.
  • The minor will not be supervised by the driver during stops. It is the unaccompanied minor’s responsibility to ensure that they remain on the bus until the journey destination.
  • No amendment to the journey destination will be accepted unless confirmed by the parents.

THE FOLLOWING MUST BE READ AND SIGNED BY THE LEGAL GUARDIANS OF THE UNACCOMPANIED MINOR

We the undersigned, being the legal guardians of the minor mentioned below, request the Partiesto accept for carriage as a passenger upon the Connector service as an unaccompanied minor. We have read and understand the stated unaccompanied minor policy. The Parties conditions apply to the carriage of passengers and baggage. We agree to and shall assure to the Parties all the protection and benefits reserved to or conferred upon the Parties such conditions. We indemnify the Parties against all actions, proceedings, claims, demands, costs or expenses incurred either directly or arising out of any noncompliance by the said unaccompanied minor with any of the said conditions. We hereby state that the minor is seven years of age or over.

DETAILS OF UNACCOMPANIED MINOR

Surname ______First name______Age ______

Travelling from ______

Travelling to ______

Travel dates______/______/ ______to ______/______/ ______

Pick up location (morning)______(afternoon) ______

Contact phone number ______

Legal Guardians to certify all details are correct and the above conditions are understood

Signed: ______Full Name: ______

Signed: ______Full Name: ______

Emergency contact number: ______(only used in emergencies)

WHAT TO DO WITH THIS FORM

1) Please fax a copy of this form to us on 06 7618363 or email to

2) Note: Unaccompanied minors will NOT be accepted for travel unless the above two steps have been followed

Other conditions

  • The agreement for the carriage of the minor can be terminated by the Parties at any time.
  • Payment of the applicable fare will be by automatic payment, monthly in arrears,on receipt of notification of the due amount from the Taranaki Regional Council.