Nonprofit Transportation Consent and Release Form
Participant Information
Full Name
Date of Birth
Phone Number
Address
Emergency Contact
Name
Relationship
Phone Number
Transportation Details
Purpose of Transportation
Date(s) of Transportation
Destination
Consent and Release
Please read and agree to the following:
I consent to be transported by the organization and release them from liability to the extent permitted by law.
I authorize emergency medical treatment if necessary.
Signature
Participant Signature
Date
Parent/Guardian Signature (if under 18)
Date