Family And Child Education & Support 育才之家

Afterschool Ride-Home Permission & Liability Waiver
课后接送回家许可及免责协议

Complete this form to authorize FACES to arrange for your student to be driven home after the afterschool program.
请填写此表,授权育才之家安排学生在课后班结束后乘车回家。

A separate form is required for each student. Please submit this form before the first requested ride.
每名学生需要单独填写一份表格。请在第一次接送前提交。

* Indicates required information / 表示必填项

Student Information / 学生信息
Parent / Guardian Contact / 家长或监护人联系信息
Ride Details / 接送安排
Permission and Liability Waiver / 许可及免责协议
Electronic Signature / 电子签名

Your typed name is your electronic signature. It must match the parent/guardian name above.
输入姓名即表示您的电子签名,必须与上方家长或监护人姓名一致。

A copy will be sent to your email and to info@yucai.org.
副本将发送到您的邮箱和 info@yucai.org。