Minor Passenger Consent Form

Minor Passenger Information

Full Name Date of Birth

Parent/Legal Guardian Information

Full Name Relationship to Minor Phone Number

Ride Details

Date of Ride Pick-up Location Drop-off Location

Emergency Contact Information

Name Phone Number

Consent & Acknowledgment

By signing below, I give my consent for the above-named minor to use the ride-share company’s service. I have reviewed and agree to the company’s policies for minors.

Signature of Parent/Guardian Date