Transportation to Youth Group

TRANSPORTATION TO YOUTH GROUP FUNCTIONS
PASSENGER
PARENT AUTHORIZATION AND RELEASE
(Please fill out completely)

Permission is hereby granted by the undersigned parent(s) or guardian(s) of:

Please enter full name and age for all Youth Members

For these persons to be transported by advisors, parents, or USY members to and from all youth group functions:

I/We, for ourselves and our spouses, do hereby agree to release and absolve Jewish Association of North Tampa, Inc., d/b/a Congregation Kol Ami, and their officers, directors, agents, servants, employees, and volunteers from all causes of action , claims or liabilities from any personal injury to the above-named youth group member or from damage or loss of the youth group member’s personal property which arises from or are incident to transportation by such above-named youth group member by an advisor, parents, or youth group member whether caused by the negligent acts of the Jewish Association of North Tampa, or their officers, directors, agents, servants, employees, permission volunteers, or otherwise.

* Parent/Guardian eSignature

* Date

Parent/Guardian eSignature

Date

* Parent/Guardian First Name

* Parent/Guardian Last Name

* Parent/Guardian Phone Number

Required for contact in case of emergency

Confirmation Email