CONSENT AND INDEMNITY

FOR THE USE OF THE KALAMAZOO COACH LINES TRANSPORT

Zion van Wyk

I, _______________________________________________ (full name and surname), the
parent/guardian of____________________________________________ herewith consent for my
child to be transported by Kalamazoo Coach Lines. I fully understand that the transport provided by
Kalamazoo Coach Lines is used and undertaken by my child/ward at his or her own risk.

I acknowledge that my child/ward will be under the control of members of the KZNSDA while being
transported on this carrier. I further acknowledge that-neither Kwazulu-Natal Schools’ Debating
Association, nor agents accept any responsibility for any loss, injury or damage and loss of life or
whatsoever that may be sustained by my child/ward while using the transport provided by Kalamazoo
Coach Lines or its agents. I waive any right that I or my child/ward may not have to claim
compensation against KZSDA, their employees or agents in respect of any loss, injury or damage
and loss of life or whatsoever that may be sustained in the course of my child/ward using the
transport provided, by Kalamazoo Coach Lines as a result of any incident that may or occur and I
indemnify Kalamazoo Coach Lines, their employees and agents against all claims.

Durban 11 December 23
SIGNED AT: ____________________________ON___________________________20_____

______________________

Medical Information
Asthma
Medical Conditions: _______________________________________________________________
-
Allergies: ________________________________________________________________________

Momentum
Medical Aid: ____________________________
Ingwe
Plan Name: ____________________________
917354947
Medical Aid Number: _____________________
1/Main member
Dependent number: ______________________

Emergency Contact number while travelling:

Linda van Wyk
Name: ________________________________________________________________________
066 357 5746
Contact Number: ________________________________________________________________