[School or Institution Name]: [Transportation Permission Form]

Valid from April 1, 2008 to May 15, 2008

Please sign, date, and return this form to: [School or institution contact name, position]

Attention: Parent(s) or Guardian(s) regarding [Child or dependent’s name]

We have had continuing discussions regarding the convenience and or necessity of allowing students to drive themselves and others to and from group functions.

Please clearly indicate the permissions and/or restrictions that apply to your child or dependent by circling Yes or No below and providing additional information where requested, if applicable.

Child/dependent as a passenger

Yes | No	My child/dependent has my permission to ride with drivers over the age of only.
Yes | No	My child/dependent has my permission to ride with any designated event driver, regardless of age or insurance.
Yes | No	My child/dependent has my permission to ride with any adult acting as chaperone or driver for an event.
Yes | No	My child/dependent has my permission to ride with the following students only (please provide students’ full names):
Yes | No	Other (please provide details):

Child/dependent as a driver

Yes | No	My child/dependent has my permission to drive him or her only.
Yes | No	My child/dependent has my permission to drive other students as passengers in a vehicle but only with copies of this permission letter in the vehicle at the time. Please note: A copy of your child/dependent’s proof of insurance form must be placed on file in advance of the event with [School or Institution Name].
Yes | No	My child/dependent may have the following number of passengers in his or her vehicle at any time (please circle the allowed number): 1 2 3 4 5 Please note: All passengers must wear a seat belt at all times when riding in a vehicle!

Additional driving restrictions

My child/dependent has the following restrictions on his or her driving:

Yes | No	No restrictions apply as long as he or she abides by the conditions of this form and all rules in effect for the group event(s) to which this form applies.
Yes | No	These restrictions apply: (please provide details, for example, no driving at night, no students or passengers of the opposite gender, allowed to drive to and from group functions only, etc.):

Please note: This form will remain on file and function as a general permission form for the dates indicated or until rescinded in writing by a parent or guardian. Additional forms specific to events will still be required as needed.

Sincerely,

[Administrator, coordinator, teacher, or principal’s name]

[Official title of position held at the school or institution

Date:	Signature of Parent or Guardian: