TO BE COMPLETED ONLY IF YOUR CHILD WILL NOT BE USING DISTRICT PROVIDED TRANSPORTATION

ATHLETIC/ACTIVITIES TRAVEL RELEASE

Athletes and activity participants will only be released to adults listed below. At no time will athletes or activity participants be released to other students

___ APPROVED ___NOT APPROVED

I, ______grant permission for my child

(Parent/Legal Guardian’s printed Name) (Child’s printed Legal Name)

to be transported home by ______from

(Printed name of vehicle driver) (Name of sport/activity)

at ______on (date) ______.

(location) (date)

REASON FOR NOT USING DISTRICT TRANSPORTATION: ______

______

I understand that, when transportation is provided, the Olympia School District requires all student athletes and activity participants to ride the bus to and from all events/activities.

·  I hereby voluntarily request a departure from the requirement to travel on the District provided transportation.

·  I understand and agree that the Olympia School District and its agents will not supervise my child after the athletic event or activity is over.

·  I understand and agree that my request for my child to travel by alternative means will release the Olympia School District from all liability for any adverse results that may occur.

I agree on behalf of myself, my child named herein, or heirs, successors and assigns to indemnify, hold harmless and defend (name of school)______and the Olympia School District, its employees, volunteers, officers, directors, agents, chaperones or representatives from any and all claims, liabilities, demands, damages, costs, expenses, or rights of action and all consequential damages arising from or in connection with this voluntarily requested alternative transportation arrangement.

This form must be on file in the site Athletic Directors’ office at least one day prior to dismissal

of school on the day of the event. This form will be provided by the school, to the Coach/Activity Director prior to leaving campus.

Parent/Legal Guardian’s Signature: ______Date: ______

Site Athletic Director’s Signature: ______Date: ______

Coach/Activity Director’s Signature: ______Date: ______

Include the “old” transfer student form

3/2016