PARENTAL PERMISSION FOR SENIORS (local WD Facilities only)

West Deptford High School
Department of Athletics
Transportation Form

The following information is being provided for the parental authorization of travel conditions and release of my daughter/son for athletic participation at the RiverWinds Community Center in West Deptford, NJ, and/or the West Deptford Baseball/Softball Little League Facilities, including Union Field and the Fieldhouse. I understand that the prevailing conditions attested to below exist solely for transportation to these facilities only!

PARENTAL PERMISSION FOR SENIOR
Note: This is for Seniors (12th graders) only.

Name of licensed and insured driver (student):

Address of licensed and insured driver (student):

Driver phone number (home):

Driver phone number (cell):

Driver’ License Number (student):

Make of Vehicle:

Place and activity that student will be travelling to:

Date for participation in this activity:

Month

Day

Year

Time frame for participation in this activity:

Hour

Minute

Reason for driver’s need to pursue this alternate means of transportation:

NO STUDENT MAY TRANSPORT ANOTHER TEAM OR ACTIVITY MEMBER TO ANY ATHLETIC OR ACTIVITY EVENT WHERE SCHEDULED TRANSPORTATION IS PROVIDED FOR THE TEAM OR ACTIVITY BY THE DISTRICT.

Student-Athlete's Electronic Signature: *

Parent-Guardian's Electronic Signature: *

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