Bus Permission Form

Bus Permission Form
Child Name

First NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
Date
2nd Child Name

First NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
Date
3rd Child Name

First NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
Date
4th Child Name

First NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
First Parent/Guardian Name

First NameMiddle NameLast NameSuffix
First Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
First Parent Email
example@example.com
Second Parent/Guardian Name

First NameMiddle NameLast NameSuffix
Second Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Second Parent Email
example@example.com
Parental Permission
The above named children has my permission to ride the bus to attend Faith Baptist Church. I do hereby agree to hold Faith Baptist Church and its agents and employees, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, even injury resulting in death, which my child now has or which may arise in the future in connection with the activity or participation in any other associated activities. I also specifically agree that Faith Baptist Church shall not be responsible for any such injuries, loss or damage even in the event of negligence or fault by Faith Baptist Church. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Illinois, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto, and the terms of this release are contractual and not a mere recital.
Signature Date

MonthDayYear
Date
Signature
Should be Empty: