Resources & Forms

Resources and Forms

  • CHAPERONE AND DRIVER INFO FOR

  • Student(s) Name(s)

    All names on this list will be checked against the Megan’s Law Website to be sure that all our volunteers are legally able to be around children under the age of 18. Please have all parents/adults who may wish to chaperone on any of the study trips for this school year read the study trip policy and provide the information in the spaces below. Also, please let the teachers know if at anytime during the school year you wish to add or remove someone from this list.
  • Date Format: MM slash DD slash YYYY
  • Drop files here or
      Please upload a scan/ copy of the following: -Your automobile insurance -Your DMV driver record
    • PLEASE INITIAL EACH STATEMENT BELOW

    • I have read the Antioch Charter Academy Driver/Chaperone Policies. I understand that it is important as a chaperone to follow these steps and I am agreeing to do so as a study trip volunteer.
    • I have enclosed a copy of my automobile insurance to show that I have a minimum of $100,000/$300,000 per occurrence in car insurance, should I choose to drive students in my car during the school year. If my automobile insurance is terminated I will immediately cease transporting Antioch Charter Academy students for school sponsored activities and events.
    • I have enclosed a copy of my DMV driver record.

    Antioch Charter Academy

    3325 Hacienda Way, Antioch, CA

    (925) 755-7311