{
    "document_id": 16662,
    "filename": "newtransportationconsent.pdf",
    "engine": "paddleocr_vl",
    "source_run_id": 16773,
    "generated_at": "2026-11-05T04:26:59+00:00",
    "page_count": 1,
    "counts_by_type": {
        "figure": 1,
        "form_field": 7,
        "header": 1,
        "heading": 7,
        "list": 3,
        "list_item": 13,
        "text": 13,
        "title": 1
    },
    "timings": {
        "total_ms": 203,
        "structure_ms": 95,
        "text_layer_ms": 13,
        "build_ms": 6
    },
    "pages": [
        {
            "document_id": 16662,
            "page": 1,
            "width": 612,
            "height": 792,
            "rotation": 0,
            "pipeline_version": "paddleocr-vl-1.6+paul-48",
            "width_pt": 612,
            "height_pt": 792,
            "engine": "paddleocr_vl",
            "source_run_id": 16773,
            "item_count": 46,
            "counts_by_type": {
                "figure": 1,
                "form_field": 7,
                "header": 1,
                "heading": 7,
                "list": 3,
                "list_item": 13,
                "text": 13,
                "title": 1
            },
            "build_ms": 6,
            "items": [
                {
                    "id": "p1.1",
                    "order": 1,
                    "type": "figure",
                    "bbox": {
                        "l": 42.96,
                        "t": 771.6,
                        "r": 151.68,
                        "b": 710.4
                    },
                    "text": "",
                    "attrs": {
                        "role": "page_header",
                        "block_label": "header_image"
                    },
                    "reading_order": 0
                },
                {
                    "id": "p1.2",
                    "order": 2,
                    "type": "header",
                    "bbox": {
                        "l": 187.2,
                        "t": 768.48,
                        "r": 491.04,
                        "b": 737.04
                    },
                    "text": "KENTUCKY STATE UNIVERSITY\nCooperative Extension Program 4-H Youth Development",
                    "attrs": {
                        "block_label": "header"
                    },
                    "level": 2,
                    "reading_order": 1
                },
                {
                    "id": "p1.3",
                    "order": 3,
                    "type": "title",
                    "bbox": {
                        "l": 219.6,
                        "t": 725.28,
                        "r": 458.16,
                        "b": 710.4
                    },
                    "text": "TRANSPORTATION CONSENT FORM",
                    "attrs": {
                        "block_label": "doc_title"
                    },
                    "level": 2,
                    "reading_order": 2
                },
                {
                    "id": "p1.4",
                    "order": 4,
                    "type": "heading",
                    "bbox": {
                        "l": 29.04,
                        "t": 695.52,
                        "r": 198.48,
                        "b": 684.72
                    },
                    "text": "TO BE COMPLETED BY PROGRAM STAFF:",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 3
                },
                {
                    "id": "p1.5",
                    "order": 5,
                    "type": "list",
                    "bbox": {
                        "l": 31.504635,
                        "t": 677.54992,
                        "r": 574.786145,
                        "b": 629.054922
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 3
                    },
                    "children": [
                        {
                            "id": "p1.5.1",
                            "order": 6,
                            "type": "list_item",
                            "bbox": {
                                "l": 31.504635,
                                "t": 677.54992,
                                "r": 570.994416,
                                "b": 666.55492
                            },
                            "text": "Program/Event Name: ___",
                            "children": [
                                {
                                    "id": "p1.5.1.1",
                                    "order": 7,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 31.5046,
                                        "t": 677.5499,
                                        "r": 570.9944,
                                        "b": 666.5549
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "Program/Event Name: ___",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.5.1"
                                    },
                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 0
                        },
                        {
                            "id": "p1.5.2",
                            "order": 8,
                            "type": "list_item",
                            "bbox": {
                                "l": 31.504635,
                                "t": 658.799921,
                                "r": 570.748944,
                                "b": 647.804921
                            },
                            "text": "Date(s):___ County/Location: ___",
                            "children": [
                                {
                                    "id": "p1.5.2.1",
                                    "order": 9,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 31.5046,
                                        "t": 658.7999,
                                        "r": 570.749,
                                        "b": 647.8049
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "Date(s):___ County/Location: ___",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.5.2"
                                    },
                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 1
                        },
                        {
                            "id": "p1.5.3",
                            "order": 10,
                            "type": "list_item",
                            "bbox": {
                                "l": 31.504635,
                                "t": 640.049921,
                                "r": 574.786145,
                                "b": 629.054922
                            },
                            "text": "Employee Name: ___ Program Area: ___",
                            "children": [
                                {
                                    "id": "p1.5.3.1",
                                    "order": 11,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 31.5046,
                                        "t": 640.0499,
                                        "r": 574.7862,
                                        "b": 629.0549
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "Employee Name: ___ Program Area: ___",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.5.3"
                                    },
                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 2
                        }
                    ],
                    "reading_order": 4
                },
                {
                    "id": "p1.6",
                    "order": 12,
                    "type": "heading",
                    "bbox": {
                        "l": 24.96,
                        "t": 609.84,
                        "r": 144.24,
                        "b": 597.84
                    },
                    "text": "Participant Information",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 5
                },
                {
                    "id": "p1.7",
                    "order": 13,
                    "type": "text",
                    "bbox": {
                        "l": 23.28,
                        "t": 593.52,
                        "r": 385.92,
                        "b": 581.52
                    },
                    "text": "Participant Name: Date of Birth:",
                    "children": [
                        {
                            "id": "p1.7.1",
                            "order": 14,
                            "type": "form_field",
                            "bbox": {
                                "l": 25.6063,
                                "t": 592.7687,
                                "r": 577.8762,
                                "b": 581.7737
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Participant Name: Date of Birth:",
                                "source": "blank_line",
                                "label_source": "parent_text",
                                "label_ref": "p1.7"
                            },
                            "reading_order": 0
                        }
                    ],
                    "reading_order": 6
                },
                {
                    "id": "p1.8",
                    "order": 15,
                    "type": "heading",
                    "bbox": {
                        "l": 388.32,
                        "t": 593.76,
                        "r": 578.64,
                        "b": 581.28
                    },
                    "text": "Date of Birth:",
                    "level": 3,
                    "reading_order": 7
                },
                {
                    "id": "p1.9",
                    "order": 16,
                    "type": "text",
                    "bbox": {
                        "l": 25.2,
                        "t": 572.16,
                        "r": 422.64,
                        "b": 560.4
                    },
                    "text": "Parent/Guardian Name: ___",
                    "children": [
                        {
                            "id": "p1.9.1",
                            "order": 17,
                            "type": "form_field",
                            "bbox": {
                                "l": 26.9284,
                                "t": 571.1287,
                                "r": 420.5927,
                                "b": 560.1337
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Parent/Guardian Name: ___",
                                "source": "blank_line",
                                "label_source": "parent_text",
                                "label_ref": "p1.9"
                            },
                            "reading_order": 0
                        }
                    ],
                    "reading_order": 8
                },
                {
                    "id": "p1.10",
                    "order": 18,
                    "type": "text",
                    "bbox": {
                        "l": 26.16,
                        "t": 550.8,
                        "r": 563.52,
                        "b": 538.08
                    },
                    "text": "Email: ___",
                    "children": [
                        {
                            "id": "p1.10.1",
                            "order": 19,
                            "type": "form_field",
                            "bbox": {
                                "l": 26.9284,
                                "t": 550.1287,
                                "r": 561.5872,
                                "b": 539.1337
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Email: ___",
                                "source": "blank_line",
                                "label_source": "parent_text",
                                "label_ref": "p1.10"
                            },
                            "reading_order": 0
                        }
                    ],
                    "reading_order": 9
                },
                {
                    "id": "p1.11",
                    "order": 20,
                    "type": "text",
                    "bbox": {
                        "l": 24.24,
                        "t": 550.56,
                        "r": 283.2,
                        "b": 538.56
                    },
                    "text": "Telephone:_____",
                    "reading_order": 10
                },
                {
                    "id": "p1.12",
                    "order": 21,
                    "type": "heading",
                    "bbox": {
                        "l": 20.88,
                        "t": 526.8,
                        "r": 165.84,
                        "b": 515.04
                    },
                    "text": "TRANSPORTATION CONSENT",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 11
                },
                {
                    "id": "p1.13",
                    "order": 22,
                    "type": "text",
                    "bbox": {
                        "l": 21.6,
                        "t": 511.92,
                        "r": 551.52,
                        "b": 486.72
                    },
                    "text": "I give permission for my child to participate in all approved program activities, including educational, recreational, and supervised off-site activities and field trips associated with the program.",
                    "reading_order": 12
                },
                {
                    "id": "p1.14",
                    "order": 23,
                    "type": "text",
                    "bbox": {
                        "l": 19.92,
                        "t": 474,
                        "r": 569.76,
                        "b": 448.32
                    },
                    "text": "I authorize my child to be transported by Kentucky State University employees, authorized volunteers, approved drivers, or contracted transportation providers, on university-approved vehicles for purposes related to camp activities.",
                    "reading_order": 13
                },
                {
                    "id": "p1.15",
                    "order": 24,
                    "type": "heading",
                    "bbox": {
                        "l": 19.68,
                        "t": 432.72,
                        "r": 349.68,
                        "b": 420.24
                    },
                    "text": "ACKNOWLEDGEMENT OF TRANSPORTATION AND ACTIVITY RISKS",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 14
                },
                {
                    "id": "p1.16",
                    "order": 25,
                    "type": "text",
                    "bbox": {
                        "l": 19.44,
                        "t": 415.2,
                        "r": 556.32,
                        "b": 390.48
                    },
                    "text": "I understand that participation in field trips and transportation to and from activities may involve certain inherent risks, including but not limited to:",
                    "reading_order": 15
                },
                {
                    "id": "p1.17",
                    "order": 26,
                    "type": "list",
                    "bbox": {
                        "l": 27.84,
                        "t": 388.8,
                        "r": 218.16,
                        "b": 327.36
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 5
                    },
                    "children": [
                        {
                            "id": "p1.17.1",
                            "order": 27,
                            "type": "list_item",
                            "bbox": {
                                "l": 28.08,
                                "t": 388.8,
                                "r": 105.12,
                                "b": 378.24
                            },
                            "text": "vehicle travel,",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.17.2",
                            "order": 28,
                            "type": "list_item",
                            "bbox": {
                                "l": 28.32,
                                "t": 376.08,
                                "r": 123.84,
                                "b": 365.76
                            },
                            "text": "outdoor activities.",
                            "marker": "•",
                            "reading_order": 1
                        },
                        {
                            "id": "p1.17.3",
                            "order": 29,
                            "type": "list_item",
                            "bbox": {
                                "l": 28.08,
                                "t": 363.12,
                                "r": 141.6,
                                "b": 352.56
                            },
                            "text": "recreational activities.",
                            "marker": "•",
                            "reading_order": 2
                        },
                        {
                            "id": "p1.17.4",
                            "order": 30,
                            "type": "list_item",
                            "bbox": {
                                "l": 28.08,
                                "t": 350.4,
                                "r": 115.92,
                                "b": 339.84
                            },
                            "text": "public locations,",
                            "marker": "•",
                            "reading_order": 3
                        },
                        {
                            "id": "p1.17.5",
                            "order": 31,
                            "type": "list_item",
                            "bbox": {
                                "l": 27.84,
                                "t": 338.16,
                                "r": 218.16,
                                "b": 327.36
                            },
                            "text": "and interaction with other participants.",
                            "marker": "•",
                            "reading_order": 4
                        }
                    ],
                    "reading_order": 16
                },
                {
                    "id": "p1.18",
                    "order": 32,
                    "type": "text",
                    "bbox": {
                        "l": 19.44,
                        "t": 326.4,
                        "r": 541.92,
                        "b": 300.72
                    },
                    "text": "I understand that Kentucky State University will take reasonable precautions to provide appropriate supervision and transportation procedures for participants.",
                    "reading_order": 17
                },
                {
                    "id": "p1.19",
                    "order": 33,
                    "type": "heading",
                    "bbox": {
                        "l": 20.4,
                        "t": 282.48,
                        "r": 174.48,
                        "b": 270.48
                    },
                    "text": "EMERGENCY AUTHORIZATION",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 18
                },
                {
                    "id": "p1.20",
                    "order": 34,
                    "type": "text",
                    "bbox": {
                        "l": 19.2,
                        "t": 267.84,
                        "r": 587.28,
                        "b": 229.44
                    },
                    "text": "In the event of illness, injury, accident, or emergency during transportation or off-campus activities, I authorize Kentucky State University staff and representatives to obtain emergency medical care for my child if I cannot be reached immediately. I understand that reasonable efforts will be made to contact me as soon as possible.",
                    "reading_order": 19
                },
                {
                    "id": "p1.21",
                    "order": 35,
                    "type": "heading",
                    "bbox": {
                        "l": 20.16,
                        "t": 213.12,
                        "r": 293.76,
                        "b": 200.88
                    },
                    "text": "BEHAVIOR EXPECTATIONS DURING TRANSPORTATION",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 20
                },
                {
                    "id": "p1.22",
                    "order": 36,
                    "type": "text",
                    "bbox": {
                        "l": 19.92,
                        "t": 196.8,
                        "r": 233.52,
                        "b": 185.28
                    },
                    "text": "I understand that participants are expected to:",
                    "reading_order": 21
                },
                {
                    "id": "p1.23",
                    "order": 37,
                    "type": "list",
                    "bbox": {
                        "l": 20.4,
                        "t": 182.64,
                        "r": 516.96,
                        "b": 118.56
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 5
                    },
                    "children": [
                        {
                            "id": "p1.23.1",
                            "order": 38,
                            "type": "list_item",
                            "bbox": {
                                "l": 27.84,
                                "t": 182.64,
                                "r": 239.76,
                                "b": 171.36
                            },
                            "text": "follow all instructions from drivers and staff.",
                            "marker": "•",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.23.2",
                            "order": 39,
                            "type": "list_item",
                            "bbox": {
                                "l": 28.08,
                                "t": 169.2,
                                "r": 178.08,
                                "b": 158.4
                            },
                            "text": "remain seated when required,",
                            "marker": "-",
                            "reading_order": 1
                        },
                        {
                            "id": "p1.23.3",
                            "order": 40,
                            "type": "list_item",
                            "bbox": {
                                "l": 27.6,
                                "t": 156.72,
                                "r": 257.04,
                                "b": 145.68
                            },
                            "text": "use appropriate behavior during transportation,",
                            "marker": "-",
                            "reading_order": 2
                        },
                        {
                            "id": "p1.23.4",
                            "order": 41,
                            "type": "list_item",
                            "bbox": {
                                "l": 27.36,
                                "t": 143.76,
                                "r": 383.04,
                                "b": 132.96
                            },
                            "text": "and comply with all safety expectations and Code of Conduct requirements.",
                            "marker": "•",
                            "reading_order": 3
                        },
                        {
                            "id": "p1.23.5",
                            "order": 42,
                            "type": "list_item",
                            "bbox": {
                                "l": 20.4,
                                "t": 131.04,
                                "r": 516.96,
                                "b": 118.56
                            },
                            "text": "Failure to follow transportation safety expectations may result in disciplinary action or removal from activities.",
                            "reading_order": 4
                        }
                    ],
                    "reading_order": 22
                },
                {
                    "id": "p1.24",
                    "order": 43,
                    "type": "text",
                    "bbox": {
                        "l": 18.96,
                        "t": 99.6,
                        "r": 577.2,
                        "b": 71.52
                    },
                    "text": "I certify that I am the parent/legal guardian of the participant listed; I have read and understand this transportation consent form; and I voluntarily grant permission for participation and transportation.",
                    "reading_order": 23
                },
                {
                    "id": "p1.25",
                    "order": 44,
                    "type": "text",
                    "bbox": {
                        "l": 21.12,
                        "t": 52.56,
                        "r": 553.92,
                        "b": 40.56
                    },
                    "text": "Parent/Guardian Signature: ___ Date: ___",
                    "children": [
                        {
                            "id": "p1.25.1",
                            "order": 45,
                            "type": "form_field",
                            "bbox": {
                                "l": 22.5111,
                                "t": 52.0914,
                                "r": 551.4484,
                                "b": 41.0963
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Parent/Guardian Signature: ___ Date: ___",
                                "source": "blank_line",
                                "label_source": "parent_text",
                                "label_ref": "p1.25"
                            },
                            "reading_order": 0
                        }
                    ],
                    "reading_order": 24
                },
                {
                    "id": "p1.26",
                    "order": 46,
                    "type": "text",
                    "bbox": {
                        "l": 182.16,
                        "t": 29.52,
                        "r": 446.64,
                        "b": 17.76
                    },
                    "text": "Kentucky State University is an equal opportunity provider.",
                    "reading_order": 25
                }
            ]
        }
    ]
}