Yard Service Permission Waiver

District

School

Grade

Student Last Name

Student First Name

Gender

Birth Date

Student ID

Land Owner

911 Address

Bus Route

Additional Student Names

Resident Name

Phone

Mailing Address

Reason

TO THE LAND OWNER:

School Division Policy requires that when it is desired to operate a bus on private land, the land owner's permission shall be obtained. In cases where the operation on land is for the benefit of the landowner, the Division is not prepared to assume additional risks and liability, therefore a waiver of compensation is also required.

Please check the appropriate statements which follow:

Permission is hereby granted to Peace River School Division No. 10 to enter onto my property with a school bus.

I hereby agree to waive any and all claims against the School Division and any and all rights to compensation for any damage or injury to premises or persons caused by normal operation of the school bus while on my property. I also agree to release the School Division from liability for the said damage or injury incurred.

Please note: Peace River School Division No. 10 reserves the right to suspend or cancel this service as its circumstances may require.

Submitted by

Last Name

First Name

Yard Service Permission Waiver

More than one student matches the criteria submitted. Please select the student to use

TO THE LAND OWNER:

Please check the appropriate statements which follow:

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