Student Name _______________________________
Snowmobile Make _______________________________
Snowmobile Color _______________________________
Registration # _______________________________
I have taken and successfully completed the Snowmobile Safety Program
Yes No
I give my son/daughter permission to ride his/her snowmobile to school. We both agree to abide by the above guidelines.
______________________________________ ____________________________
Parent/Guardian Signature Date
_____________________________________ ____________________________
Student Signature Date
APPROVED: January 9, 2003
12/21/2004 pw