Kaʻa 'Ōhua ʻOhana Information

Kaʻa 'Ōhua ʻOhana Information
I have read and understand the rules of the bus. I further understand that failure to follow the rules will result in dismissal from bus service. Initial*
Mother/Guardian's Name*
Mother/Guardian's Signature*

Clear
Mother/Guardian's Morning Phone*
Mother/Guardian's Afternoon Phone*
Father/Guardian's Name
Father/Guardian's Name

Clear
Father/Guardian's Morning Phone
Father/Guardian's Afternoon Phone
Physical Home Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
At the time of bus drop off by the Ka 'Umeke bus, I would like my child to:

a. Be dismissed to walk home.b. Be dismissed to stay at the drop off site until I pick him/her up.c. Must return to campus where I will pick him/her up.d. Be released to the following emergency contact person(s) whom I have notified and will come for him/her.
EMERGENCY CONTACT OTHER THAN PARENT/GUARDIAN

These contacts are authorized to pick-up your child at the bus stops
Name
Relation
Morning Phone
Afternoon Phone
Name
Relation
Morning Phone
Afternoon Phone
Name
Relation
Morning Phone
Afternoon Phone
Should be Empty: