Student Passenger Waiver & Activity Release
Complete this in advance for approved school activity travel in a private vehicle—excluding home-to-school commuting.
Student Driver Name
*
First Name
Last Name
Student Driver Age (must be at least 16 and under 21)
*
School
*
Please Select
Antimony Elementary
Boulder Elementary
Bryce Valley Elementary
Bryce Valley High
Escalante Elementary
Escalante High
Panguitch Elementary
Panguitch Middle
Panguitch High
Garfield Online
Activity or Event
*
Date(s) of Travel
*
Vehicle Description (make, model, year, color)
*
Certifications
*
The vehicle is covered by liability insurance
The vehicle has passed the state-required safety inspection
I waive claims against Garfield County School District for liability arising from this travel, and I agree with the disclaimers contained within the School District Activity Release Form (Policy FFC).
Student Driver Signature
*
Passenger Names (enter one name per line)
*
Passenger Signature
*
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Signature (this travel is at the request of the parent/guardian)
*
Date
*
-
Month
-
Day
Year
Date
Submit Waiver
Submit Waiver
Should be Empty: