PASSENGER LIABILITY WAIVER

Driver Statement:

I understand that unauthorized persons should not be transported in state vehicles and have been granted an exception by an appropriate supervisor. After the passenger has signed the waiver, I will forward this form to the Fleet Coordinator.

Vehicle: _____________________________________

Signature of Driver: _________________________________    Date: ______________

Passenger’s Waiver:

I understand that the Delgado Community College and the State of Louisiana assume no liability for any loss, injury, or death resulting from transportation in the state vehicle listed below:

_____________________________________  _______________________

Passenger (or Guardian if Passenger is a Minor)      Date

Form 1382/002 (9/04)

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