2019-2020 Pilot Transportation Program Form

  1. Pilot Transportation Program
  2. Payment
  3. Review

Pilot Transportation Program

REGISTRATION FORM & CONSENT AND RELEASE
Registration is available on a first-come, first–served basis as space is limited based on bus capacity. Registration is complete for each individual student rider upon: 1. Receipt of payment of the registration fee of $100 per child (non-refundable, non-transferable) AND 2. Receipt of this Registration Form, which includes the signature of both parents’ and/or guardians for dual parent/guardian households, acknowledging the Consent and Release and an understanding of the Transportation Safety Guidelines for our students.
*
*
Choose your route and stop below:
Note*: The JCC route is AM service only. Afternoon transportation to the JCC will continue to be available through Club J registration.

I/We,
*
am/are the parent and legal guardian of
*
(“Student”). Student is enrolled in The Alfred and Adele Davis Academy (Davis Academy) for the 2019/2020 school year. We I/We acknowledge that I/we are responsible for the transportation of Student and are hereby contracting with Vaughan Bus Service and Samson Tours Inc, independent third party entities (the “Bus Company”) to provide such transportation for Student. Davis Academy has, at its direction, supplemented the transportation costs of the Bus Company on a voluntary basis for this school year.
By signing this waiver, I/we do so understanding the inherent risks and liabilities involved in the transportation of students. I/We acknowledge that the Bus Company is unrelated to Davis Academy, is an independent third party, and that Davis Academy does not make any representations about the Bus Company or its employees. I/we assume ALL RISKS inherent and otherwise, known and unknown, including, without limitation, risks of death, personal or bodily injury, disability or property damage resulting from, in connection with, or in any way related to the transportation of Student.
By signing below, I/we hereby, jointly and severally, and intending to legally bind myself/ourselves and Student agree to release, discharge, promise not to sue, and hold Davis Academy and its predecessors, successors, and assigns, as well as all of their respective representatives, agents, owners, officers, directors, shareholders, managers, partners, employees, staff, volunteers, and supervisors, past and present, harmless from and indemnify them against all claims, demands, suits, charges, fees, attorneys’ fees, costs, damages, liens, liabilities, and actions of any kind whatsoever arising out or connected with, directly or indirectly, the transportation of Student. I/we certify that all of Student’s living parent(s) and/or legal guardian(s), as applicable, have duly signed this document. This document also evidences my/our waiver and release of all and any claims, damages, liabilities, actions, costs, or expenses which I/we or Student may have against Davis Academy arising in any way out of Student’s travel to/from Davis Academy with the Bus Company. The types of claims I/we hereby release include contract claims, statutory claims, torts of any kind, negligence, intentional acts, economic and non-economic damages, expenses, costs, insurance claims, attorneys’ fees, or any other type of claim.
I/We have signed this document knowingly, willingly, and after having an opportunity to consider its implications. I/We have read and reviewed the Transportaion Safety Bus Guidelines with my child and we mutually agree to follow such guidelines.

**BOTH PARENTS/GUARDIANS MUST SIGN**
*
*
*

Lower School

770.671.0085

 

Middle School

770.804.9191

 

© 2019 The Alfred & Adele Davis Academy