School Bus Solutions Registration Form

School Bus Solutions Registration Form

Please complete this form to register your child for transportation services. All information is kept confidential.
Student Details:
Full Name*

First NameLast Name
Age/Grade*
School Name*
Primary Pickup Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Drop-off Location (School, Daycare, or Home)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 1:*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Parent/Guardian 2:

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact 1:*

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to Child
Emergency Contact 2:

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to Child
Type of Service*

Round trip (morning pickup & afternoon drop-off)One Way—Morning Pickup OnlyOne Way-Afternoon Drop-off OnlyAfter-School Program Drop-off (school dismissal - after-care location)
School Start Time (Bell Time)*
School Dismissal Time*
Duration of Service*

Short-Term (temporary service minimum of one full week, 3 days per week or more, up to 3 months during the school year)Long-Term/Ongoing Service (for the full school year or continuous service, minimum 3 days per week; e.g., daily school pickup/drop-off, after-care program drop-off, or regular 3-5 days per week)
Does your child have any allergies or medical conditions or require any medications during transportation? (If none, write N/A)*
(Policy Notice):

School Bus Solutions staff do not carry, hold, or store medication in vehicles. Daily medications should be kept at home or with the school nurse. Children may carry emergency medication (such as an inhaler or EpiPen) in their backpack if permitted by the parent/guardian.
EpiPen / Emergency Response Policy (Multiple Choice):*

My child carries an EpiPen; I authorize a trained driver to assist if necessary.My child carries an EpiPen; I do not authorize administration; call 911 onlyMy child does not require an EpiPen.
(Emergency Protocol):

In the event of a severe allergic reaction (anaphylaxis), which may include symptoms such as.
- Trouble breathing or wheezing
- Swelling of lips, tongue, or throat
- Hives, rash, or flushed skin
- Dizziness, fainting, or loss of consciousness
School Bus Solutions staff will:
- Call 911 immediately.
- Contact the parent/guardian.
- Allow the child to self-administer if able.
- A trained driver may assist with administering the EpiPen only if:
- The parent/guardian has given written consent, and a doctor authorization form is on file, and the driver has completed EpiPen training.
- If no authorization is provided, staff will not administer the EpiPen and will wait for EMS.
Food Policy:

Eating is not permitted on buses/vans for safety and allergy reasons. If your child requires a snack or has special dietary needs, please inform us in advance.
Authorized Pickup Information: If none, write N/A. Please list anyone besides the parent/guardian who is allowed to pick up your child. Also note anyone who is not allowed to pick up your child. *
Special Equipment

Car Seat RequiredBooster Seat RequiredWheelchair Assistance Required (Note: Vans are not wheelchair accessible at this time.)
Does your child need assistance going inside the school building?*

YesNo
Does your child need assistance entering/leaving before or after care?*

YesNo
Photo/Video Permission*

Yes, for internal/safety only (example: ID purposes, attendance/logs, or internal records; not shared publicly)Yes, for public/promotional use (example: website flyers or social media).No, I do not give permission for my child's photo/video to be taken.
Disclaimer:

School Bus Solutions will never sell or share images with third parties. Photos are used only for safety, internal records, or promotional purposes if permission is granted.
Emergency Medical Consent*

Yes, I authorize staff to seek emergency medical treatment (EMS/hospital) if necessary. This does not include daily or routine medication.No, I do not authorize medical treatment
Preferred Communication Method*

CallTextEmail
Custody/Legal Restrictions we should be aware of? (If none, write N/A)
Any additional notes or special instructions? (If none, write N/A)
How did you hear about School Bus Solutions?*

Word of MouthSchool/Daycare ReferralSocial Media (Facebook, Instagram, etc.)Website/Google SearchOther
Will you be willing to recommend us?

YesNoMaybe
By submitting this form, I confirm that the information provided is accurate and agree to notify School Bus Solutions of any changes to my child's health, contact, or transportation details.
Parent/Guardian Signature

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"This registration form is the property of School Bus Solutions. Unauthorized use or duplication is prohibited."
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