PICKENS COUNTY COLLEGE AND CAREER CENTER DRIVING WAIVER OF LIABILITY 2021-2022

PICKENS COUNTY COLLEGE & CAREER CENTER

COMMERCE AVE. – BOX 387

CARROLLTON, AL 35447

205-367-1230 FAX 205-367-1122

MR. SHAWN MCDANIEL, CAREER TECHNICAL DIRECTOR-PRINCIPAL
RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT. FOR THE 2020-2021 SCHOOL YEAR. REQUESTING PERMISSION FOR A STUDENT TO DRIVE A MOTOR VEHICLE, AND OR TRANSPORT STUDENTS IN A MOTOR VEHCILE AND OR BE A PASSENGER IN A MOTOR VEHICLE DRIVEN BY ANOTHER STUDENT.
The undersigned student and parent/guardian request the Pickens County Board of Education Board, Superintendent, Principals and other agents, servants or employees of The Board (hereinafter collectively referred to as School System) to grant permission so that Student may be allowed to drive a motor vehicle and or transport student passengers in a motor vehicle and or be a student passenger in a motor vehicle between the home school to and from the Pickens County College & Career Center.

IT WILL BE THE SOLE RESPONSIBILITY OF THE STUDENTS’ PARENTS/GUARDIAN TO MAKE THE ARRANGEMENTS.

The undersigned expressly authorize such travel and represent to School System that Student has in effect a valid driver’s license issued by the State of Alabama allowing Student to drive which is neither suspended nor revoked. Also, there is in full force and effect a policy of liability insurance covering such motor vehicle in such amount as required by the State of Alabama. Such insurance (or comparable policy) will be kept in effect so long as Student remains enrolled in the Pickens County School System. Attach a photocopy of Student’s driver’s license and insurance card or other proof of liability coverage.

In the event of suspension, cancellation or revocation of either the driver’s license or insurance policy, the undersigned shall immediately notify School System. In such event, any permission granted by School System to Student shall immediately terminate.

The undersigned voluntarily release and waive any and all claims against School System, both present and future, arising out of or in any way connected with Student’s use of a motor vehicle pursuant to this authorization including, but not limited to, claims for breach of contract, express or implied, or for acts or failure to act, or wrongful death. The undersigned do hereby release, waive and discharge School System and covenant that they will not institute any suit, claim, or action against School System for any loss, damage, or injury, to person or property, arising out of School System’s grant of permission to Student to drive a motor vehicle, whether such is caused by the Student, School System, or a third party. The undersigned also agree to indemnify and save harmless the School System against any and all claims for damages, loss or injury, costs or expenses, including reasonable attorney’s fees, that arise out of , or are made as a result of, Student’s use of a motor vehicle pursuant to this request.
The undersigned have read and voluntarily executed this document, including release, waiver of liability, and indemnity agreement. No oral representations, statements, or inducements apart from this written document have been made. We agree that this request is voluntary and the undersigned assume all risks of loss, damage, or injury that might be sustained as a result of Student’s operation of a motor vehicle pursuant to permission granted by School System.

The undersigned agree that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Alabama, and that if any portion is held invalid, the remaining provisions shall continue in full force and effect.
COMPLETE ONLY THE SECTION(S) THAT APPLY
MY STUDENT IS AUTHORIZED TO DRIVE A VEHICLE TO THE CAREER CENTER
Student Driver's Name
Parent or Guardian's Name
Month
Day of Month/Year
Year
Student Driver Signature

Clear
Parent/Guardian of Student Driver
2*MY STUDENT MAY TRANSPORT OTHER AUTHORIZED STUDENTS IN A VEHICLE:
Day of Month/Year
Month
Year
Student Driver Signature

Clear
Parent/Guardian of Student Driver
3*MY STUDENT MAY BE A PASSENGER IN ANOTHER AUTHORIZED STUDENT’S VEHICLE:
Month
Day of Month/Year
Year
Student Passenger Signature

Clear
Parent/Guardian of Student Passenger
ATTACH A PHOTOCOPY OF CURRENT PROOF OF INSURANCE AND DRIVER’S LICENSE
Should be Empty:

COMPLETE ONLY THE SECTION(S) THAT APPLY

MY STUDENT IS AUTHORIZED TO DRIVE A VEHICLE TO THE CAREER CENTER

2*MY STUDENT MAY TRANSPORT OTHER AUTHORIZED STUDENTS IN A VEHICLE:

3*MY STUDENT MAY BE A PASSENGER IN ANOTHER AUTHORIZED STUDENT’S VEHICLE:

ATTACH A PHOTOCOPY OF CURRENT PROOF OF INSURANCE AND DRIVER’S LICENSE