Student Transportation Form

Appendix G.6 (Exception Form) Roman Catholic Diocese of Phoenix

TRANSPORTATION OF MINOR PERSON TO/FROM SCHOOL CAMPUS

The Catholic Diocese of Phoenix “Diocesan Policy and Procedure for the Protection of Minors” as it pertains to Diocesan Personnel provides, in part, that “Field trips or other outings involving a minor in places and situations where no other responsible adults are present…” are to be avoided. The directive of this provision requires that another adult should accompany Diocesan personnel who transport minors to and from field trips and outings.

Because of the limited number of participants and the time of day in which program events will occur, it may not always be possible to have two adults occupying each vehicle transporting minors to and from the programs.

The Diocese permits exceptions to this policy only upon a showing by the school that:

1) a school has made reasonable efforts to have two adults present in such vehicles, but without success; and

2) a parent or guardian of any student participating in such program has consented in writing to allow such student to be transported in a vehicle occupied by only one adult. However, for the exception to apply the parent/guardian of the minor person must consent in writing. I, , of (name of parent/guardian) (name of minor student) have selected one of three alternatives below by checking the applicable box to indicate selection:

Parent's First Name *

Parent's Last Name *

Parent's Email *

Student's names (Separated by commas) *

CONSENT OF PARENT/GUARDIAN TO ALLOW FOR EXCEPTION TO POLICY

I, parent/guardian of the students named above, a participant in the extracurricular activities of OLMC, hereby consent to allow the students named above to travel to and from program events in a vehicle occupied by a single adult person with other students at any time during the school year. I further acknowledge that I have instructed my minor child to occupy only the rear seat(s) of such vehicle. I agree that if I wish to revoke this consent I will do so in writing and deliver such revocation to the Principal of the school.

E Signature *

Today's Date *