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Students Only
On-Vehicle - Vehicle Service and Repair
Students Only
Vehicle Service & Repair Hold Harmless Waiver
I _____________________ acknowledge that all repairs done on my vehicle will be performed by
a student trainee. I also agree to hold Palm Beach State College, its students, administrators,
instructors and staff free and harmless from and against any and all losses, claims, liabilities,
negligence and/or expenses associated with any repair performed to my vehicle by a college
student trainee. I further understand that the privately owned vehicles of staff, non-Automotive or
Diesel students, and faculty (other than Automotive/Diesel faculty) of Palm Beach State College
or any other personally owned vehicles are NOT allowed to be serviced or repaired by students.
Owner: __________________________
Student: _______________________
Signature: ________________________
Signature: _______________________
Date: ______________
Student ID: _______________
Make: ________________
Model: ______________ Year: ___________
Decal No: _____________________ Tag No. ___________________
Other:
Copy Verify proof of auto insurance.
Copy of owners Driver’s license.
Copy of Car Registration.
Student must supply all parts and supplies.
_____________________________
____________________________
Instructor Signature
Authorization Signatures
Program Director/
Admin Assist
This document requires all signatures before entering the car to the lab facilities. Failure to do
this will result in not allowing vehicle to come in the labs for any reason again.
NO VEHICLE CAN BE LEFT OVERNIGHT WITHOUT FURTHER AUTHORIZATION BY THE
PROGRAM DIRECTOR.
NATEF STANDARD 7.15
REVISED 05/19/2015
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