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Pipeline Transportation Form

While I agree that Norwich Free Academy policy is for Pipeline students to be transported to and from Three Rivers Community College (TRCC) classes and clinicals with the rest of the Pipeline cohort, we realize there may be times when parents/guardians may need to provide more direct transportation for students. This form must be completed and approved in advance in order for the Pipeline Coordinator to notify the TRCC faculty.

Required

Student Namerequired
First Name
Last Name
Parent/Guardian transporting studentrequired
First Name
Last Name
Must contain a date in M/D/YYYY format
Please include where you are going to or from on the day of transport.

I understand that the Norwich Free Academy policy indicates that students are to travel via the provided transportation. By requesting a waiver I agree to indemnify and hold the Norwich Free Academy, its officers, agents, and employees harmless from any and all claims or loss for bodily injury or property damage arising out of such independent travel.

It is understood that I will assume full responsibility for my student's health and safety.

CNA Pipeline students are not allowed to transport themselves to TRCC class.

My signature indicates: That I have read and agree to NFA's terms and conditions regarding indemnification and waivers for student transportation.

Type your name to digitally sign this document.