Shuttle Registration 2022-23

Carondelet Shuttle Registration 2022-23

Please use this form to make a reservation on the Carondelet Shuttle for the 2022-23 school year
Reservation

Reservation is for the full year at a rate of $1,200.

Carondelet students and their De La Salle siblings will be billed through their Carondelet tuition management account.

DLS students without a CHS sibling will be sent a link to pay. DLS students who have not paid in full will not be allowed to ride the bus.

Carondelet Bus ridership is cancellable and refundable for unused service on the first day of the month following written notice received by CHS Business Office. Please email ssproul@carondeleths.org with any questions or if you need to cancel ridership.

In this form you will make your reservation, provide student information, emergency contact information, and sign a release.
Student Name *

First Name Last Name
Student ID Number
Student Email *
Student Grade 2022-23 *

9th 10th 11th 12th
School *

Carondelet De La Salle
Does this student have a sibling who will be a Carondelet student in 2022-23? *

Yes No
Pickup Location *

Livermore (Livermore Park-n-Ride) – 6:45 AM Pleasanton (Stoneridge Park-n-Ride) – 7:05 AM Danville (Sycamore Park-n-Ride) – 7:25 AM
Emergency Contact 1
Name *

First Name Last Name
Relation to Student *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Emergency Contact 2
Name *

First Name Last Name
Relation to Student *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Billing Information

DLS students who do not have Carondelet siblings will need to submit additional information to be billed for shuttle usage.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
Transportation Authorization and Release

I hereby authorize and give full consent to approved bus transports, parents, employees or volunteers for Carondelet High School to transport the below-named minor(s) to and from school (also for school sponsored programs or events).

I am AWARE of and ASSUME ALL RISKS associated with the above-named minor(s) traveling to and from such activities by means of private or public transportation, which may include but are not limited to a motor vehicle accident resulting in physical injuries, death, or other injury to psyche or property.

I also agree to release, indemnify, hold harmless, waive and relinquish all claims that I may have against Carondelet High School and its employees, volunteers, agents, directors, officers, contractors, partners and affiliate organizations, and Carondelet High School arising from or in connection with any type of injury/loss sustained as a result of the below-named minor's participation in such activities or transportation to and from such activities.
I have read and understand all parts of this form. I understand that this is a LEGAL AGREEMENT binding upon myself, my heirs, executors, administrators, successors, and assigns. I acknowledge that by signing this agreement voluntarily, I am agreeing to abide by its terms and I am waiving certain legal rights that I or the above-named minor(s) may have.

The electronic signature below and its related fields are treated by Carondelet High School like a physical handwritten signature on a paper form.
Parent/Guardian Signature *

Clear
Confirmation Email *
Should be Empty:

Carondelet Shuttle Registration 2022-23

Reservation

Emergency Contact 1

Emergency Contact 2