BRIEN MCMAHON HIGH SCHOOL
ALTERNATE TRANSPORTATION REQUEST FORM
This is to request that __________________ be permitted to ride by vehicle other than the school bus
Name of Athlete
(to/from/both ways) at the _____________________________on ____________________ at
Circle One Activity Date
____________________________. I certify that I have arranged transportation for the above-named
Location of Activity
student. He/She will be riding with ___________________________________, _________________,
Name of Driver Relationship
a responsible adult. The reason for not riding the bus is _____________________________________
I understand that Brien McMahon High School rules require that students ride the buses to and from all school events and that by requesting a departure from this requirement I will release the Norwalk Board of Education and City of Norwalk from all liability for any accidents that may occur. I understand that I (or the other parent or guardian driving the vehicle) assumes all liability for this alternative transportation under our personal automobile insurance policy.
I therefore agree to release the Norwalk Board of Education and the City of Norwalk and its employees and officers from all liability with reference to the above stated alternate transportation.
This form must be in the Athletic Office prior to or on the day of the event.
Parent or Guardian Date