TRANSPORTATION WAVIER FORM

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Student Name*

Grade*

Pick Up Address*

Drop Off Address*

Contact Number*

From Date*

To date*

Parent Name*

Parent Contact Number*

Parent Signature*

Please give your consent by clicking on the option given below:*

• I hereby give permission for my child to be picked up and dropped off from the above mentioned address.. I take the full responsibility of my child in any case.