Volunteer Transportation Contract/Request Form

Case Number:

Child(ren) Names:

DOB: - -

DOB: - -

Date: - -	Purpose:

Location/Destination:	Approx.Duration: ______________________________________________________________________________________

I understand that CASA Montgomery County and CASA Advocate, ,

in the course of working on behalf of the above named child(ren), may transport the child(ren) by

car on the above date and time and so give my permission.

The goals of transporting children are:

To develop and enhance the trust and bond between the Advocate and the child;

To foster open and more effective communication; and

To give the child a sense of a “normal life” experience.

(It is NOT the goal of CASA to provide routine transportation for which CPS or the caregiver should be responsible.)

CASA Montgomery County Advocate agrees to abide by all child safety and restraint laws while transporting children in Texas Department of Family Protective Services custody.

I have read and understand the CASA Montgomery County Transportation Policy and agree to abide by all the rules and laws. I accept all liability for this transport.

_____________________________/_________	_____________________________/_________

CASA Advocate/Guardian ad Litem Date	CASA Program Director Date

_____________________________/_________

CASA Case Supervisor	Date

______________________________________________________________________________________

Initial CPS/CASA Approval	Training

Auto Insurance w/coverage amts	TX DMV DL	TX MVR