B6b-PARENT WAIVER AND PERMISSION FOR TEENAGE DRIVER TO TRANSPORT YOUTH
B6b-PARENT WAIVER AND PERMISSION FOR TEENAGE DRIVER TO TRANSPORT YOUTH
Select Youth group below
*
Delta GEMs
Delta Academy
EMBODI
DEEP
Cotillion
PARENT WAIVER AND PERMISSION FOR TEENAGE DRIVER TO TRANSPORT YOUTH
ALL TEENAGE DRIVERS MUST HAVE A NON-PROVISIONAL DRIVER’S LICENSE
Name of child being transported
Name of child being transported
*
First
Last
Event
*
Location
*
Name of Teenage Driver
Name of Teenage Driver
*
First
Last
(Note: If giving permission for the driver to transport youth to all activities, please indicate “ALL” for Event & Location)
I give permission for my child (“child”) to transport the individual identified above in a motor
vehicle to the event at the specified location. I understand my child is expected to follow all
applicable laws regarding driving a motor vehicle and is expected to follow the directions provided by all motor vehicle laws.
I have read, understand, and discussed with my child that:
1) They will be driving a vehicle with other youth participants, and they are to wear their safety belts while traveling.
2) They are expected to respect the vehicles they ride in and the person they travel with during the trip.
3) Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions, or acts by riders, other drivers, or objects.
I recognize that by participating in this activity, as with any activity involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this
activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses.
As a condition for the transportation received, I, for myself, my child, my executors and assigns, further agree to release and forever discharge Delta Sigma Theta Sorority, Incorporated and the Chapter from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation. I have read this entire waiver and permission form, fully understand it, and agree to be legally bound by its terms
Teenage Driver Parent/Guardian Name:
Teenage Driver Parent/Guardian Name:
*
First
Last
Teenage Driver Parent/Guardian :Draw your signature into the box below.
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
Date
Date
*
/
MM
/
DD
YYYY
Submit