WOODLAND ATHLETIC DEPARTMENT Alternate Transportation Form

Parents must check box and fill out section 1 in the case of an instance where a school related activity, religious commitment or unavoidable family business precludes riding the team bus provided by Region 16. -OR- Parents must check box and fill out section 2 in cases where transportation is not provided by Region 16 (such as a special tournament or individual state tournament). The athlete’s parents are responsible for transportation if the athlete wishes to participate. ------

Section 1: I request that (name of athlete) ______be allowed to ride: (circle one) TO FROM TO & FROM

(site)______on (date)______at (time)______.

______I certify that I will be transporting the above named student-athlete personally. -OR- ______I have arranged for alternative transportation for him/her with another adult.

(Name of Alternate Driver)______

NOTE: Students are not permitted to drive themselves to or from athletic competitions.

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Section 2: I understand that Region 16 will not be providing transportation on (date)______to (site) ______for (activity) ______and I assume the responsibility for transporting (name of athlete) ______to this event.

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I understand that Woodland Regional High School rules state that where Region 16 provides transportation, students are to ride buses to and from all school events. By requesting this departure from this requirement, I will release Woodland Regional School District 16 and the towns of Beacon Falls and Prospect from all liability for any accidents that may occur. I, therefore, agree to release the Region 16 Board of Education and the Towns of Beacon Falls and Prospect and its employees and officers from all liability with reference to the above stated alternate transportation.

THIS FORM MUST BE IN THE ATHLETIC OFFICE PRIOR TO OR NO LATER THAN THE DAY OF THE EVENT. ATHLETE IS TO PRESENT COPY OF SIGNED FORM TO THE COACH ON GAME DAY.

______Parent/Guardian Signature Athletic Director Signature