Acelerate Academy Transportation Form

Student's Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent's Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Please enter a valid phone number.

Permission Statement

I, the undersigned parent/guardian, Parent's Name permit Accelerate Academy & Reading Tutor Rx and its authorized staff to transport my child Child's First Name Last Name off school premises for approved educational or recreational field trips during the following period, Date
I understand that transportation may be provided by a school-owned vehicle, a charter bus, or a staff member’s vehicle. I authorize my child to participate in such trips and consent to their travel under the supervision of school staff.
I acknowledge that field trip destinations may vary and that specific details (date, time, and location) will be provided before each trip. I understand that reasonable safety precautions will be taken. Still, I release and hold harmless Accelerate Academy & Reading Tutor Rx, its employees, and agents from any liability, claims, or expenses that may arise from transportation and participation in these activities, except in cases of gross negligence or willful misconduct.
In the event of an emergency, I authorize the supervising staff to secure necessary medical treatment for my child. I understand I will be responsible for any costs incurred.

Signature

Date