Special Needs / Unaccompanied Minor Release Form
Unaccompanied Minor/Special Needs forms are required for special needs passengers and/or minors less than 16 years of age.

Wickkiser International Companies, Inc. and CWA, Inc., dba Airporter Shuttle, require all minors less than 16 years of age to have a Special Needs/ Unaccompanied Minor Form on file at our main office in Ferndale, WA, in order to travel on our shuttles.

Airporter Shuttle is responsible for the transportation of the passenger. To assist guardians in the safety of minor passengers we recommend that they direct the minor to sit in front of the shuttle and avoid conversation with all persons other than the driver. We do not assume responsibility for the passenger once they exit the vehicle, whether this be at an intermediary stop or their final destination. Airporter Shuttle specifically is not assuming the role of a guardian of the minor or special needs passenger.

NOTE: Children between the ages of 12-15 years may travel on our shuttles without a parent or guardian. Children less than 12 years old MUST be accompanied by a parent or guardian.

Please fill this out completely to authorize the transportation of your Minor / Special Needs passenger. ONE FORM PER PASSENGER. You must be the parent or legal guardian of the Minor / Special Needs passenger to fill out this form. Thank you!
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Part 1: Parent or Guardian - PLEASE NOTE:

1. This form is to authorize transportation for an unaccompanied Minor / Special Needs passenger between the ages of 12-15 years old. Children under the age of 12 MUST BE ACCOMPANIED BY AN ADULT. Passengers 16 years old or older do not need a form to travel unaccompanied on our buses.

2. The Minor / Special Needs passenger will be getting off our bus by themselves.

3. One form per passenger. If you have multiple passengers, you will need to fill out multiple forms.

4. Airporter Shuttle does not assume any other responsibility for the unaccompanied Minor / Special Needs passenger other than providing transportation between the pick-up and drop-off locations.

4. This release needs to be valid for either a single date or a range of dates.
 
Part 2: Parent or Guardian Information

 
What is your full name? *

By answering this, you declare yourself as the parent or legal guardian to the Minor / Special Needs passenger(s).
 
What is your address? *

Include street address, city, state and zip code.
 
What is your phone number? *

Cell phone number preferred. We will use this to contact you on the day(s) of travel, and/or for any changes in schedule.
 
What is your email address? *

Be sure to use one that you check regularly.
 
Part 3: Minor / Special Needs Passenger Information

One form per passenger.
 
Name of Minor / Special Needs passenger *

One form per passenger. If you multiple passengers, you must complete a separate form for each.
 
Date of Birth of Minor / Special Needs passenger *

 
Pick-Up Location and Drop-Off Location

 
Is this form for a range of dates, or for a single day of travel? *

Range of dates is for multiple trips into the future. If you choose Range of dates, we'll keep this form on file until the end date you specify.

 
Did you want to specify a date range, or just keep this form on file until the passenger's 16th birthday? *


 
For this range of dates, what is the START date? *

 
And what is the end date? *

 
What is the day of travel? *

 
Which of our two Airporter routes will your Minor / Special Needs passenger be using? *


 
At which Airporter Shuttle pick-up location will your Minor / Special Needs passenger be boarding our bus?


 
At which Airporter Shuttle drop-off location will your Minor / Special Needs passenger be getting off our bus?


 
At which Airporter Shuttle pick-up location will your Minor / Special Needs passenger be boarding our bus?


 
At which Airporter Shuttle drop-off location will your Minor / Special Needs passenger be getting off our bus?


 
Part 5: Alternate Contact Information

This is in case of transportation emergency only. We suggest this should be the contact info for the parent / guardian meeting the Minor / Special Needs passenger(s) at the drop-off location.
 
Name of Alternate Contact

 
Cell phone number for Alternate Contact

 
Part 6: Authorization *

My Minor / Special Needs passenger, {{answer_20015714}}, will be getting off the Airporter Shuttle bus by him/her self at the Drop-Off location of {{answer_20015945}}.

I, {{answer_20015372}}, authorize that I am the parent or legal guardian of the passenger and I hereby authorize Airporter Shuttle to provide transportation between the pick-up and drop-off locations of {{answer_20015856}} and {{answer_20015945}}, respectively.

I understand that Airporter Shuttle is not acting as a guardian for the passenger while on board the vehicle nor once the passenger has left the vehicle, whether en route or at the final destination. Airporter Shuttle is responsible for the transportation of the passenger only.


     
Thank you! We've received your form. And thanks for choosing Airporter Shuttle for your transportation needs.

Need to fill out additional forms for additional Minor / Special Needs passengers? Click the button below.
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