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# TRANSPORTATION CONSENT FORM

## TO BE COMPLETED BY PROGRAM STAFF:

Program/Event Name: ___

Date(s):___ County/Location: ___

Employee Name: ___ Program Area: ___

：

## Participant Information

Participant Name:  Date of Birth:



Parent/Guardian Name: ___

Telephone:_____

Email: ___

## TRANSPORTATION CONSENT

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.

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.

## ACKNOWLEDGEMENT OF TRANSPORTATION AND ACTIVITY RISKS

I understand that participation in field trips and transportation to and from activities may involve certain inherent risks, including but not limited to:

vehicle travel,

• outdoor activities.

• recreational activities.

• public locations,

• and interaction with other participants.

I understand that Kentucky State University will take reasonable precautions to provide appropriate supervision and transportation procedures for participants.

## EMERGENCY AUTHORIZATION

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.

## BEHAVIOR EXPECTATIONS DURING TRANSPORTATION

I understand that participants are expected to:

• follow all instructions from drivers and staff.

- remain seated when required,

- use appropriate behavior during transportation,

• and comply with all safety expectations and Code of Conduct requirements.

Failure to follow transportation safety expectations may result in disciplinary action or removal from activities.

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.

Parent/Guardian Signature: ___ Date: ___

Kentucky State University is an equal opportunity provider.