Crutches Waiver Form

Certification of Knowledge and Release

I, the Parent/Guardian of this student, request that above listed student be allowed to ride the school bus provided by Lakeland School Corporation. I hereby state that the student named has a current medical condition that requires the use of crutches, and that the use of crutches to enter/exit a school bus may present a hazard to my student that could lead to further injury. I have explained to my student the need to enter/exit the school bus in a manner that is safe for my student, and the other students riding the school bus. I also understand that my student’s crutches must be stowed on the bus in a manner that provides a safe environment for my student and the other students on board, and that the bus driver may direct my student as to the best way to accomplish this. Therefore, I voluntarily release Lakeland School Corporation and its employees of any liability in the event that my student receives further injury while entering, exiting, or riding the school bus while under this medical restriction.

Due to limited seating capacity, the Lakeland Transportation Department may not be able to accommodate requests that a student sit alone due to their injury.