USD 251

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USD 251 NORTH LYON COUNTY

Superintendent Aron Dody Clerk Nicky Nuessen

Board of Education Matt Horton, President Sally Anderson, Vice President Angela Anderson Tim Burton Allen Curless Earl Lyddane Eric Wooderson

Box 527 Americus, Kansas 66835 Phone: 620-443-5116 Fax: 620-443-5659

Treasurer Amy Hoy

“THE BEST STUDENTS IN THE WORLD ARE LEARNING HERE!”

Dual Activities Transportation Waiver Date: Time: I, _________________________________, the legal guardian for, __________________________________, (parent name) (student name) herby give permission for, _______________________________ ,to transport himself/herself to practices when (student name) school transportation is not available due to, ___________________________________ ,participating in dual (student name) activities. In signing this waiver, I herby understand that I am releasing USD 251 of any liability and responsibility

for, _________________________________, while he/she is transporting himself/herself to practice. I, (student name) ___________________________________, also agree by signing this waiver that I will not pursue any litigation or (parent name) financial restitution in the event that, ________________________________, is in an accident while transporting (student name) himself/herself to practice. Furthermore, it is understood that, ____________________________________, will (student name) take the most direct route to practice and not deviate from the most direct route to make side trips, transport other passengers, or run errands.

My signature below indicates that I agree with the above terms of this waiver. ___________________________ (student signature)

_________________________ (parent signature)

_______________________ (administrative signature)

DISTRICT ATTENDANCE CENTERS AMERICUS ELEMENTARY Aron Dody, Principal 804 6th Street, Box 497 Americus, Kansas 66835 620-443-5165

NORTHERN HEIGHTS HIGH SCHOOL David Kehres, Principal 1208 Road 345 Allen, Kansas 66833 620-528-3521

READING ELEMENTARY Peggy Fort, Principal 1st & Osage, Box 38 Reading, Kansas 66868 620-699-3827