• File: JJHA-E-1 - SHARON SCHOOLS - TRANSPORTATION PLAN - EXTRACURRICULAR ACTIVITI


    File: JJHA-E-1

    SHARON SCHOOLS - TRANSPORTATION PLAN - EXTRACURRICULAR ACTIVITIES

    TRANSPORT BY PARENTS/GUARDIANS

    Print   Name of Student/Participant (on line   above)

    Print   Student’s Parent or Guardian Name (on   line above)

    Daytime   Phone Number

    Print   Student’s/Parent’s Address, City, Zip Code (on line above)

    Evening   Phone Number

    IDENTIFY SPECIFIC EVENT/ACTIVITY

    Start   date:

    End   date:

    (Month/date/year)

    (Month/date/year)

    1. Have you, the Parent/Guardian, determined that your Student/Participant will not use school-provided transportation for the Event/Activity identified above?

    Yes

    No

    1. Do you, the Parent/Guardian, plan to transport your Student/Participant to and from the Event/Activity identified above, on each day of the Event/Activity?

    Yes

    No

    If your answers to A and B above are Yes, please complete the following:

    AUTHORIZATION, with RELEASE AND INDEMNIFICATION

    I, _____________________ (print name), am the parent or guardian of the Student/Participant identified above, who is a student at ___________________________ (print name of school). With my knowledge and permission, the Student/Participant has elected to participate in Event/Activity that I have described above ("Event/Activity").

    I acknowledge and understand that Sharon students occasionally travel to other schools or other sites (separately or collectively, "Site") outside of Sharon for school-related or associated events/activities. I further understand that the Sharon School Department routinely and ordinarily arranges for free transportation for students to travel to and from these events/activities, including the Event/Activity identified above. Nonetheless, at my request, in order to accommodate the Student/Participant identified above (who wishes to travel to/from the Event/Activity by means other than transportation arranged by the School Department), and in exchange for the School Department's allowing the Student/Participant to participate in the Event/Activity, I accept and agree as follows:

    Because I have voluntarily chosen and elected to transport the Student/Participant myself in connection with the Event/Activity (or to arrange for other transport for the Student/Participant), I understand that it is my responsibility, not the School Department’s, to assure that the Student/Participant safely travels to and from the Site where the Event/Activity is taking place. By signing below I release, discharge and agree to defend, indemnify and hold harmless the Town of Sharon, the School Committee, School Department and all their past, present and future officers, agents, servants, employees and attorneys (collectively “Town of Sharon”) from any and all liability, whatsoever for any and all damages, loss or injuries (including death), sustained by the Student/Participant or his/her property, or both, including but not limited to any third-party claims, demands, causes of action, judgment, damages, expenses, and costs, including attorney’s fees and costs of suit, which arise out of, occur during, or are in any way connected to the Student/Participant’s travel to and from the Event/Activity (and related Site).

    I represent and agree that I will not transport any other Sharon students in connection with the Event/Activity listed above (and related Site), unless such students are also members of my family and/or siblings of Student/Participant.

    I agree that if any portion this document is held to be invalid, the balance hereof shall, notwithstanding, continue in full legal force and effect.

    In signing this document I hereby acknowledge that I have read this entire document, that I understand its terms, that by signing it I am giving up substantial legal rights I may otherwise have, and that I have signed it knowingly and voluntarily.

    By my signature below, I also certify and represent that I have legal custody of the Student/Participant by reason of the fact that I am the parent of the Student/Participant, or his/her legal guardian by court order.

    Student Participant

    Date

    Parent or Legal   Guardian

    Date

    Revised:December 11, 2013