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Dream
Limousine Service
209-664-1213 or
800-998-9248
TCP-19918
High School Prom / Formal Release and
Indemnity Agreement
Dream
Limousine Service is delighted in the fact you
have chosen this safe and responsible form of
transportation for your son or daughter. Prom
night is a special time; an evening filled with
anticipation, excitement, and a memorable
evening for your child’s high school year. For
your child’s safety and your peace of mind, a
couple of rules are set forth and must be agreed
to by all parents and students:
Rules of the
Road
1.
The
solid and glass divider between the driver and
near passenger compartment will remain down at
all times.
2.
There
will be no smoking, no drinking alcohol, no
illegal drugs, and no weapons of any kind, no
intimate relationship or misconduct, and or any
body parts out of the windows of said
vehicle.
3.
The
possession and consumption of any alcoholic
beverage by a minor is against the law. By
signing your name below, you agree that there
will be NO alcoholic beverages
consumed
or transported in the limousine.
If
at any time during the limousine ride any
student is suspected of, or witnessed to have
consumed, or found in the possession of any
illegal substance, including alcohol or drugs;
The Driver will immediately terminate the
limousine ride. The Driver will notify the
consenting parent that a violation of the rules
has occurred and ALL vehicle occupants
(students) will be returned to the consenting
parent /Guardian’s home address. All monies
paid, including chauffeur gratuity shall be
forfeited.
On behalf of my child and
myself each of the undersigned
hereby:
1.
Waive,
release, and discharge Dream Limousine Service,
its employees, agents and contractors, from any
and all claims relating to my or my child’s
participation in prom activities and limousine
service provided by Dream Limousine
Service.
2.
Assume
any and all risks of property damage to the
vehicle, and release and hold harmless Dream
Limousine Service from any all liability for
personal or property damage except due to Dream
Limousine Service gross negligence or
intentional acts;
3.
Indemnify
and hold Dream Limousine Service harmless from
any loss, liability, damage, cost or expense,
including litigation, which may incur as a
result of any personal or property damage which
my child participated in while in the vehicle;
4.
Reimburse
Dream Limousine Service for any loss or damage
or cost Dream Limousine Service may incur due to
the vehicle not being able to be returned to
service.
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Dream
Limousine Service
TCP-19918
209-664-1213 or
800-998-9248
High
School Prom / Formal Release and Indemnity
Agreement
I
have carefully read this Release and Indemnity
Agreement and fully understand its contents. I
am aware that this is a release of liability and
a contract between myself and Dream Limousine
Service, and that I sign it of my own free
will. |
Parents
Name_____________________ Parents Signature
_______________________
Cell Phone:
_______________________Home Phone Number:
___________________
Student
Name: _____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
____
Student
Name:
_____________________Student
Signature___________________________
Student
Name: _____________________Student
Signature___________________________
_
Student
Name: _____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
Student
Name:
_____________________Student
Signature___________________________
____
Student
Name:
_____________________Student
Signature___________________________
Student
Name: _____________________Student
Signature___________________________
Date______________________________
Drivers
Name_______________________________
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