Pathways Request for Permission to Drive

Name
First Last
Dear Parent, due to scheduling issues, there are times that the cooperative students will need to provide their own transportation. Students are not allowed to have passengers or be a passenger in another student's vehicle.
Please check all of the following items that pertains to your son/daughter named above.
- My child has my permissino to drive his/her car to cooperative classes when approved by director.
- My child has my permission to ride as a passenger on a school provided bus for fieldtrips.
- I have adequate health insurance for my child.
- My child has adequate health insurance through their home school.
- I do not have insurance for my child and will provide a written statement indicating the reason.
Signature
Name
First Last
Date
MM slash DD slash YYYY
Phone
Email