* Minor Release Form *                       

                       DRUG & ALCOHOL STATEMENT

The main motto of our organization is to give quality service to our clients.

Luxor Coach Limousine does not support any kind of addiction to drugs by any individual.If a minor has
any illegal substance in the limousine (even cigarettes), the rental will be terminated without refund.

The parents/guardians and proper authorities will be notified of such conduct.
According to the law, the consumption of any drug by a minor is strictly prohibited.
If any minor is found at the start or during the charter in the possession or consumption of drugs he/she
will forfeit further charter. The responsible party will be contacted at that time.
Passengers will be dropped off at their original position from where they were picked up.
The contract will be terminated and the responsible party will have therefore forfeited their charter time
with full payment collected and no refund granted.
Payment in full is due and signatures required before charter begins.

Signature of Parent/Guardian:_____________________________________

I have read and understood the Minor Release Form Drug and Alcohol Statement above completely. I agree with
the terms above and will fully comply with Luxor Coach Limousine. I understand and am fully aware of the
consequences involved regarding any illegal substance.

Signature of Minors and Date of Birth Required

1.  ______________________________________________________      D.O.B_________________________
2.  ______________________________________________________           _________________________
3.  ______________________________________________________           _________________________
4.  ______________________________________________________           _________________________
5.  ______________________________________________________           _________________________
6.  ______________________________________________________           _________________________
7.  ______________________________________________________           _________________________
8.  ______________________________________________________           _________________________
9.  ______________________________________________________           _________________________
10. ______________________________________________________           _________________________
11. ______________________________________________________           _________________________
12. ______________________________________________________           _________________________
13. ______________________________________________________           _________________________
14. ______________________________________________________           _________________________
15. ______________________________________________________           _________________________



Signature of Chauffeur:__________________________________________ Date:__________________________

Release and Indemnity Agreement