Carpool parental authorisation form

AUTHORIZATION LETTER FOR THE TRANSPORT OF A MINOR IN CARPOOLING

I, the undersigned, Mr/Mrs .................................................................... authorize my child .....................................................................of whom I am the Father/Mother/LEGAL GUARDIAN to ride in the vehicle of Mr/Mrs ................................................... on ...../...../.......... at ........h....... (specify date and time) from ........................................... to ............................................ (specify departure and arrival cities, as well as pick-up and drop-off locations).

* I hereby certify being aware of the risks linked to a transport in carpooling and give my consent for this carpooling to happen.

Driver:

Last name / First name: ...............................................................................

Full address: .................................................................................................

Mobile phone: ...................................... Home phone ............................... Work phone: .........................

Email: ....................................................................

The minor:

Last name/ First name: .......................................................................

Date of birth: .......................................................................

Father / Mother / Legal guardian:

Last name / First name: ............................................................................

Full address: .............................................................................................

Mobile phone: ...................................... Home phone ............................... Work phone: .........................

Email: ....................................................................

Person to contact in case of emergency:

Last name / First name: ............................................................................

Full address: .............................................................................................

Mobile phone: ...................................... Home phone ............................... Work phone: .........................

Email: ....................................................................

Done in two copies in ................................................ on ....../....../….…. (City and date of signature)

[Signature FATHER/MOTHER/LEGAL GUARDIAN]

[Signature DRIVER]