PARENTAL / GUARDIAN AUTHORISATION FORM
Name: ______Age: ______
Booking Number: ______Service Number: ______Date: ______
TRAVEL DETAILS
From: ______To: ______
Departing Address: ______Arriving Address: ______
______
Contact Name: ______Contact Name: ______
Telephone Number: ______Telephone Number: ______
Disclaimer:
- I, the undersigned, certify I am the parent or guardian of the above-named minor(s).
- I certify the minor(s) are to travel alone and agree to and request the unaccompanied carriage of minors.
- I also agree to and accept that the following terms are the conditions upon which Tambray Coaches (ABN 78 392 149 879) agree to the unaccompanied carriage of the minor(s).
a)"a minor" shall mean a person who is no younger than 10 years and no older than 15 years.
b)"the carrier" shall mean and include Tambray Coaches, it's servant’s agents and employees.
c)The carrier accepts no responsibility for the protection, care (including medical care), custody, control and/or supervision, funds for food and/or general sustenance, of the minor(s) at any time or at any place, whether in transit or otherwise, including:
i)the place of departure.
ii)the place of destination
iii)stopping places whether shown In the Carrier's timetable as scheduled stopping places or otherwise.
d)The carrier accepts no responsibility for injury and inconvenience of any kind whatsoever (including death, injury, delay or loss) arising out of, or incidental to any failure by the Carrier to protect, care for, control and/or supervise the minor(s), whether or not such injury or inconvenience be due to negligence on the part of the Carrier or otherwise howsoever, and the parent or guardian for him/herself, the minor(s) and their executors, administrators and dependants expressly renounces all claims against the Carrier in respect thereof, whether they be due to negligence on the part of the Carrier or otherwise.
4. I confirm that I am responsible for any arrangements for the minor(s) to be accompanied to the place of departure and until the time of departure and for the minor(s) to be met and collected on arrival at the place of destination.
5. I authorise the Carrier to make any arrangements they consider necessary to ensure the minor(s) safe custody and wellbeing at the time or place and I agree to indemnity and reimburse the Carrier for all its costs and expenses incurred in undertaking such action. I understand that Clauses 3 a), 3 b), 3 c) and 3 d) above apply to this authorisation and that this authorisation taken by the Carrier pursuant to it is subject to those clauses.
6. I certify that all information provided by me is true and correct.
Name of Parent/Guardian: ______Date: ______
Signature: ______Tambray Signature: ______
RESERVATIONS: 1800 039 043
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