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UNACOMPANIED MINOR FORM

Child's Name
Parent's/Guardian's Name
Work Phone
Home Phone
Address
Sex
/
Date of Birth & Age
Parent's/Guardian's Name
Home Phone
Work Phone
Address
Postcode

Alternative Emergency Contacts

Primary Emergency Contact
Home Phone
Work Phone
Address
Postcode
Secondary Emergency Contact
Home Phone
Work Phone
Address
Postcode

Medical Information

GP Surgery
Doctors Name
Postcode
Phone Number
Allergies/Special Health Considerations

PARENTAL CONSENT:

I understand that the staff will take reasonable care of the minor(s) named in this form, should the necessity arise; do you give permission for the person on duty to give consent on your behalf for medical treatment to be administered in an event of an urgent medical situation or in an emergency. /

PARENTAL CONSENT:

I give permission for my child to travel unaccompanied with a driver or guardian appointed by Annisa cars.

Parent's/Guardian's Signature
Date
Parent's/Guardian's Signature
Date

Data Protection Act. The information being collected on this form will only be used for administration, safety and safe handling of minors. The data will not be disclosed to any external sources without your written consent, other than in an emergency.

TO THE PARENT/GURDIAN

Please read and ensure that you and your child understand all guidelines to ensure a safe and pleasant journey.

The child understands that:

  1. The child must remain seated at all times when the vehicle is moving.
  2. The child must not leave the vehicle without asking the drivers permission.
  3. The child must tell the driver if anyone or anything is bothering him/her, or if you need help.
  4. You must follow the driver’s instructions at all times.
  5. The child must wait for the driver to escort him/her when they arrive at the destination.

The Parent understands that:

  1. Your child will not be left unattended during the entire journey.
  2. You are to confirm that you have arranged with the school/organisation for a nominated person to receive the child at the destination.
  3. Should the child not be met at the destination as stated. I authorise Annisa cars employee or agent to take whatever action necessary to arrange for the child’s safe custody.
  4. Any health issues/allergies that the child has must be disclosed prior to any Journeys booked.
  5. You are to certify that your child understands and will follow our regulations outlined above.

Conditions:

  1. The Company shall not be responsible for any loss or damage incurred by the child.
  2. The nominated adult, described on the Boarding Pass, shall meet the unaccompanied child at the destination; and satisfactory proof of identity must be produced in the form of driver’s licence, passport, over 18’s card or similar.
  3. These conditions shall be read in addition to the company’s standard conditions of carriage and shall in no way alter, waive or modify those conditions. In consideration of the Company agreeing to carry the passenger described above (being an unaccompanied minor), I accept and agree to the conditions set out above and hold the Company indemnified against any loss or damage it is or may be liable for because of any act of omission or commission by the passenger.
  4. Unaccompanied children between the ages of 5 and 15 (inclusive) will be carried provided that an Unaccompanied Minor Form has been completed prior to any journeys made. The Unaccompanied Minor Form must be completed by the legal Parent/Guardian stating address and telephone numbers and any special health considerations.
  5. A Boarding Pass is also needed and this will be issued by us and will need to be handed over to the driver on the day of the booked journey with name, address and telephone number of person(s) meeting the child at the destination. The parent/guardian nominated on the unaccompanied minor form must be present at the departure point with the child/children for their safety and wellbeing and assist the child/children to board the vehicle at the start of their journey.
  6. A boarding pass must be present and filled then handed over to the driver for each journey, the Boarding Pass will need to be signed at the destination and a copy of this and a text message will be sent to the Parent/Guardian when safe handover has been completed.
  7. Any issues that arise during your child(s) journey please contact the office immediately.
Parent’s/Guardian’s Signature
Date
Email Address
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