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Transportation Services

Reaching Clarity Homecare

Transportation Liability Waiver

Please complete the waiver in its entirety.

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Client/Client’s Representative Name

First

Last

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Reason for Transportation:

I request transportation services from Reaching Clarity, Inc. I recognize and acknowledge that Reaching Clarity, Inc. is neither a common carrier nor in the business of providing transportation services to the public.

I Accept and Acknowledge

I further recognize and acknowledge that there are certain risks of physical injury to vehicle passengers, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity, that I may sustain as a result of participating in any and all activities connected with or associated with receiving transportation services, including, but not limited to, injuries, damages, loss and death arising out of negligent operation or supervision of the vehicle. I further agree to waive and relinquish all claims I may have (or accrue to me) against Reaching Clarity, Inc., including its respective officials, agents, volunteers, employees, and contractors (hereinafter collectively referred to as “Party”).

I Accept and Acknowledge

I understand that all Reaching Clarity Homecare employees, contractors, and volunteers, who are employed/contracted by Reaching Clarity, Inc., who are assigned transporting duties, are required to have valid drivers’ licenses, and carry sufficient vehicle insurance including Personal Injury Protection.

I Accept and Acknowledge

I understand that Reaching Clarity, Inc. checks their employees’ driving records to ensure they are free from infractions.

I Accept and Acknowledge

I understand that Reaching Clarity, Inc. reviews the currency of employees' drivers licenses and motor vehicle insurance coverage but does not perform safety inspections or monitor maintenance on employee-provided or employee-owned vehicles.

I Accept and Acknowledge

I understand that Reaching Clarity, Inc. does not provide vehicle insurance for employee-owned vehicles.

I Accept and Adknowledge

I do hereby fully release and forever discharge the Party from any and all claims for injuries, damages or loss that I may have, or which may accrue to me and arising out of, connected with, or in any way associated with said transportation services.

I Accept and Acknowledge

I further agree that this agreement shall be governed by the laws of the State of Georgia.

I Accept and Acknowledge

I have read and fully understand the above waiver and release of all claims. I voluntarily agree to sign this Transportation Liability Waiver.

I Accept and Ackownledge

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Client Signature

Date

Client’s Representative Signature

Date

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Transportation Liability Waiver

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