Transportation Responsibility Release Form

I hereby release the  ________________ Athletic Department from its portal-to-portal

responsibility for     _

(Athlete’s First and Last Name)

contest on _

.(Date of Event)

Event for this date: _

(sport)

Coach:

_____________ will not be liable and/or culpable for any injuries, accidents, or other harm that may occur when the student is released to another party for transportation.

The above-named student will only be released to the following person(s):

Release to:     _

(Please print names legibly)

Student Signature:                                                                               _

Parent's Signature:

Date received by Athletic Director: _

This form must be on file with the Athletic Director before the team leaves school.