Optional
permission/waiver regarding transportation of children in vehicles
I,________________________,
hereby authorize ________________________ to be transported by ____________=
____________
in a motor vehicle for the following purpose(s)
_____________________________=
___________________________________________________________________________=
___________________________________________________________________________=
________________________________________________________________
I have read the
material of this document regarding automobile insurance coverage and (check
one of the following):
_____ I am satisfied based on=
my
own review that the Child Care Provider or other person I have authorized to
transport my child has adequate automobile insurance coverage and that the
provisions of the automobile insurance policy specifically cover injuries a=
nd
deaths arising out of an automobile accident occurring during the course of
conducting a child care business.
_____ I specifically agree to=
hold
the Child Care Provider (or other person I have authorized to transport my
child) harmless from any claim or suit at law based on a death or injury to=
my
child caused by the negligence of the Child Care Provider or authorized dri=
ver
during the course of transporting my child by motor vehicle as authorized a=
bove
to the extent that such loss is not otherwise covered by the terms of the C=
hild
Care Provider’s or authorized driver’s automobile insurance pol=
icy.
______________ =
&nb=
sp; =
__________________________________________
(Date)___=
______________________________
(Signature of parent/guardian)
<= o:p>