BCSSMA

Organizing High School Drag Racing in B.C

Student Transfer Form

This form is to be used if a student is participating in a B.C.S.S.M.A. organized event and being supervised by a school other than the student’s own school.

Please Read Carefully

This Transfer Form acknowledges that the student’s home school is allowing him/her to attend a B.C.S.S.M.A sanctioned event(s) under the direct supervision of another school. Parental forms must also be signed and the both School Districts must have approved of these B.C.S.S.M.A. events. This form must be signed by the student’s school Administrator and by the receiving school’s Administrator and designated representative (Teacher).

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STUDENT: _________________________________

Address: __________________________________________________

__________________________________________________ Phone # ___________________

_________________________________________ _________________________________________ __________________

Student Signature Date

_________________________________________ _________________________________________ __________________

Parent Signature Date

_________________________________________ _________________________________________ __________________

Parent Signature Date

STUDENT’S SCHOOL: ________________________________________________________

S.D. # ___________

Address: __________________________________________________ Phone # ___________________

__________________________________________________ Fax # ___________________

_________________________________________ _________________________________________ __________________

School Administrator Signature Date

SCHOOL RECEIVING STUDENT: _______________________________________________

S.D. # ___________

Address: __________________________________________________ Phone # ___________________

__________________________________________________ Fax # ___________________

We agree to accept the student from the above named school.

_________________________________________ _________________________________________ __________________

Receiving School Administrator Signature Date

_________________________________________ _________________________________________ __________________

Designated School Representative Signature Date

*Completed form must be kept with designated school representative supervising student.