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It is agreed between the Board and _____________________ the transporting individual, that _______________________ being parent or guardian of the following named child or children, __________________________________________________________________________________________________________________________________
Is to transport or cause to be transported said children at his/her own risk, safely, regularly, promptly and comfortably to and from the _____________________________School, located in ______________________ for a term of _____ months Of the 20_____/20______ school year, for the sum of  _________ per mile, to be paid __________________________ by orders drawn upon the funds of said school district.
Dated this ______ day of _____________, 20 _____, at ______________________, State of Wisconsin.

Signed:   
District Administrator: _____________________________
District Clerk or Board President: ___________________
Transporting individual: __________________________
Parent or Guardian: ______________________________