Upper School AP Testing Driver Release Form

1. Driver Release Form - May 2012

This Driver Release Form should be completed by parents with children currently taking an AP course at Breck School.

Indicate your choice on this electronic form and submit it by Monday, April 30. Complete a separate form for each of your children enrolled in an AP course.

Thank you!

By completing this form, I certify that my son/daughter has my permission to be transported to and/or from Breck School Anderson Ice Arena, located at 4210 Olson Memorial Highway in Golden Valley, for AP testing between the dates of May 7-18, 2012.

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* 1.

Student First Name:

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* 2.
Student Last Name:

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* 3. Indicate your transportation choice below:

My son/daughter will ride the Breck bus.

My son/daughter has independently made alternate transportation arrangements and will not be riding the Breck bus. I have reviewed and approved my son/daughter’s alternate transportation arrangements. I understand that Breck is not responsible for the transportation of my son/daughter.

This form, with reference to the above stated transportation, must be on file in the College Counseling Office prior to the dismissal of your student on the day of the testing. If a student fails to turn in the form, he/she will not be allowed to take the AP exam.

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* 4. Please, carefully read the terms of the following liability release prior to submitting:

I approve the arrangements made for my son/daughter to travel to the Breck School Anderson Ice Arena. I hereby acknowledge, understand and agree that Breck School, its trustees, administrators and employees shall not be responsible or liable for any harm or damages of any type whatsoever arising during the transporting of my son/daughter, including but not limited to death, personal injury, and property loss or damage.

Yes

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* 5. Parent/Guardian First and Last Name

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* 6. Parent Email Address:

Thank you! You will NOT receive a confirmation upon completing this form. Please complete one form per student.

Questions? Contact Nancy Dohr in the College Counseling Office (nancy.dohr@breckschool.org or 763-381-8258).

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* 1. Student First Name:

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* 2. Student Last Name:

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* 3. Indicate your transportation choice below:

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* 5. Parent/Guardian First and Last Name

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* 6. Parent Email Address:

* 1.

Student First Name:

* 2.
Student Last Name: