Adopted:  06/23/1980

Revised:  01/26/1994, 02/19/2007                                                                   751.2 -Exhibit

School District of Prairie Farm

Bus Pick Ups and Drops Release (form)

Bus Pick Up and Drop Off Alternate Arrangement

Mr. and Mrs.____________________________, parents of _______________________,

a student of the Prairie Farm School District, hereby indemnify and hold the District, its officials, agents and employees, harmless against any and all claims, demands, suits, orders, judgments or other forms of liability that may arise out of

________________________________'s authorization to allow

(name of parents)

________________________________ to walk home from

(name of student)

______________________________________________________________.

(point of departure from bus)

Mr. and Mrs._______________________________ hereby acknowledge that this waiver

is made knowingly and with the intent to release the District and its officials, agents, and  employees of any and all liability which could arise out of this alternative bussing  arrangement.

Dated this ________ day of ___________________________, 20_____.

  By ___________________________________

       (name of parent)

 By ___________________________________

  PRAIRIE FARM SCHOOL DISTRICT

LEGAL REF.:  Sections 115.76(3) Wisconsin Statutes 121.51 - 121.56

CROSS REF.:  443.2, Student Conduct on School Buses

751 Student Transportation Services

751.2  Bus Pick Ups and Drops