Adopted:  04/15/1991

Revised:  02/19/2007                                                                                       752.1 -Exhibit

School District of Prairie Farm

Special Use of School Buses

Please read the following carefully.

I, ___________________________________, being a district resident over 25 years of age, agree to the following and accept responsibility for the use of school bus(es) to be used by (group or organization)_____________________________________________ on __________________________________.

In submitting this request I certify that the above named organization is service/educational in nature.  (Cross out wither word which may not apply).

I agree to the following conditions for use of school bus(es) owned by the Prairie Farm School District.

1.         More than 50 percent of participants reside within the Prairie Farm School  District.

2.         Each proposed rider is covered by family health/accident insurance through a family plan or through special arrangements made by my organization.

3.        I know of no special circumstances in which supplemental bus insurance is to be required.

4.         I have also priced the needed transportation service from a commercial carrier and find that the cost is in excess of 25 percent higher than estimated by the Prairie Farm School District Administrator.

5.         I certify that the agenda to which we are seeking transportation is educational/ service/entertainment/other in nature.  (Cross out words which do not apply - define other if crossed out).

6.   I certify that if our group uses a bus driver other than a School District Bus  Driver, that driver shall possess all necessary state of Wisconsin credentials and licenses required for the legal operation of the bus.

 I have read and agree to the above rules:                       Permission granted by:

__________________________________                __________________

(Name)                                                                        District Administrator

__________________________________               ___________________ 

(Address)                                                                     (Date)

__________________________________

(City, State, Zip code)

__________________________________

(Phone)                                    (Date)

CROSS REFRENCE:  742 Authorized Use of School District Equipment

                                     752 Special Use of School Buses

RATES:

The 2007 rates for bus use are as follows:

1. $1.75 per mile when using a non-district fully licensed and insured driver.

2.  $1.75 per mile plus the driver's daily rate or ratio there of when using a district bus driver.