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2901 S. Highland Drive, #6A, Las Vegas, NV 89109
Office: (702) 437-1900 Fax: (702) 260-0725
www.EarthLimos.com
Parental Consent Form Once this form is completed, please scan and e-mail to: [email protected]
or Fax to: (702) 260-0725
The Following minor ______________________________________ has my permission to use
(Print Name of Minor)
EARTH LIMOS AND BUSES for transportation on ________________________________,
(Date) I understand, I will be the primary contact, and I will be responsible for minor child, as well as having
the other minor children’s parents signing this consent form. We will be responsible for any irregular
behavior by the children, and we agree that no alcoholic beverages or other prohibited substances will
be brought into the vehicle. We are fully aware that upon any infraction of this agreement all monies
shall be forfeited.
SIGNATURE ____________________________ _____________________ __________ Parent or Guardian Print Full Name Date
ADDRESS
___________________________________________________________________________ Number and Street City, State and Zip
PHONE ______________________________ ___________________________________ Home number Cellular Number
PASSENGERS’ AGREEMENT FOR LIMOUSINE SERVICE
The consumption of any alcoholic beverage is unlawful when consumed by a minor. There will be no
alcoholic beverages transported in the passenger compartment of the vehicle. This rule will also apply
to any and all illegal substances. If at any time, any passengers are found to have in their possession,
or have been at any time during the course of service, been consuming alcohol or illegal substances,
the service shall be terminated. The Driver has the option of returning to the point of pickup or
ending service at the point of infraction. The parent will be contacted immediately. The Driver shall
also have the right to determine if they contain any illegal substances. The Driver will only follow
the route agreed upon by the Guardians.
*** If Additional Minor Passengers are on board, Parental Consent is Required, See
additional Attachment***
2901 S. Highland Drive, #6A, Las Vegas, NV 89109
Office: (702) 437-1900 Fax: (702) 260-0725
www.EarthLimos.com
A separate signature of all passengers’ parents is required to ride in the vehicle and by
their signature, is subject to the same terms above.
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
____________________________________ ________________________________ Parents or Guardian Minor Passengers Name
