Form - Transportation Permission - Heritage Academy Pinnacle

Transportation Permission

Please fill out the form below.

TRANSPORTATION PERMISSION SLIP
This permission slip is intended to cover Heritage Academy scholars that ride on Heritage Academy provided transportation. This transportation allows scholars to participate in elective courses being held on campus and as a relief to parents from the burden of transporting their students to games and events.
My scholar, whose name is below, has my permission to be transported to and from Heritage classes, games, and events on Heritage Academy provided transportation. I understand that such transportation may be on rented cars, vans, and/or chartered buses. It is understood that every necessary precaution will be taken to ensure students’ safety. Beyond this, I agree to hold Heritage Academy harmless in the event of any injury to my scholar while s/he is participating in off campus activities.
Students Name*
First Last
Parent/Guardian Name*
First Last
Email*
Parent/Guardian Primary Phone*
Type of Phone*
Parent/Guardian Secondary Phone
Type of Phone
Signature*
Date*
MM slash DD slash YYYY
STUDENT DRIVING/RIDING IN PRIVATE VEHICLE
Transportation to and from activities may be provided by private vehicle or walking. I understand that in some cases students may be driving their own vehicles to and from games, practices, or other Heritage Academy events.
In the event that alternative private transportation is used in lieu of transportation provided by Heritage Academy, Heritage Academy has no responsibility for the conduct of the driver/vehicle and has no responsibility for ensuring that the driver of the vehicle has accurate insurance and/or license.
In the event that a scholar uses alternative or private transportation, I agree to one of the following:*
- I give my permission for my son/daughter to drive a private vehicle to and from activity.
- I give my permission for (Names of Riding Students) to ride with my son/daughter to and from activity.
- I give my permission for (Riding Student's Names) to ride in a private vehicle driver by (Driving Student's Name) to and from activity.
Name(s) of Riding Student(s) (If Applicable)*
Riding Student's Name(s)*
Driving Student's Name*
Parent/Guardian Name*
First Last
Email*
Parent/Guardian Primary Phone*
Type of Phone*
Parent/Guardian Secondary Phone
Type of Phone
Signature*
Date*
MM slash DD slash YYYY
Note: Before any scholar is permitted to participate in Heritage Academy activities requiring school transportation, this permission from must be signed and submitted. NO EXCEPTIONS.
Name
This field is for validation purposes and should be left unchanged.