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Date: ______________________
Student Name: ______________________________
Dear Parent/Guardian,
On _____________________ your student's class will be taking a fieldtrip/excursion to _____________________.
Students will be transported to the event in private vehicles driven by the parents/guardians of students in the class. It is
important to understand that the Linn-Mar Community School District's insurance carrier does not provide primary coverage for the owner, driver, or passengers during a fieldtrip/excursion in non-school vehicles even though the event is sponsored by the school district.
Please check one:
_____ I give my permission for my student to go on the fieldtrip/excursion.
_____ I do not give my permission for my student to go on the fieldtrip/excursion.
Parent/Guardian Signature and Date: __________________________________
I agree to provide transportation in my own vehicle for the school fieldtrip/excursion. I understand that the Linn-Mar Community School District's insurance carrier does not provide primary insurance coverage for private vehicles and that my insurance coverage will be liable in the event of an accident.
Driver's Signature and Date: _______________________________
Adopted: 3/00
Reviewed: 3/13; 4/14; 6/15; 7/19; 7/22
Revised: 11/10
Related Policy: 1005.6