Registration Form
Please allow 24-48 Hours for a response from our Administrator.
Requested Start Date
*
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student's School Name
*
Please Select
Burchett Elementary
John Winship Elementary
Lewis Eugene Smith Elementary
McNabb Elementary
Rickey C. Bailey Middle School
Legacy the School of Sports Sciences
Dekaney High School
Not listed
School Not Listed?
Enter the school name for route consideration. *Transportation is not guaranteed until availability is confirmed **
Student's First & Last Name
*
First Name
Last Name
Grade
*
Please Select
PRE-K
Kinder
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
12th
Service Requested
*
Please Select
Round-trip
Single-trip (Morning)
Single-trip (Evening)
Parent/Guardian Name
*
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Student's Pickup Address
*
School start time (Earliest Time)
*
School dismissal time
*
Emergency Contact if Parent/Guardian is unavailable
*
First Name
Last Name
Relationship to student
*
Any Allergies? If so please advise.
List any allergies
Medications
List any medications or conditions here
Back
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Please review the Transportation Handbook and download for your records!
Please sign and acknowledge that you have read and understood the Scholar Shuttle Transportation Handbook
*
Liability Waiver
*
I hereby certify that my child(ren) is/are in good physical condition and do/does not suffer from any disability that prevents or limits his/her participation in all activities conducted by Ladies and Gents' Transport. I acknowledge that Ladies and Gents' Transport will not assume any responsibility or liability for personal injury or damages caused by the injury. In the event Ladies and Gents' Transport is unable to reach a parent, guardian or any emergency contact, I hereby give permission for my child(ren) to be transported to the nearest hospital for treatment in case of an accident or emergency. I hearby further authorize(s) any of the the staff or employees to provide for, approve and authorize health care at hospital.
Photo Release/Media
*
I hereby grant and authorize Ladies and Gents' Transport the right to take, edit, copy, publish, distribute and make use of any and all pictures or video taken of my child(ren) to be used in and/or for legally promotional materials and digital communications. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing. I understand and agree that these materials shall become the property of and will not be returned.
Refund Policy
*
All transportation payments are non-refundable and non-transferable. Payment reserves your scholar’s seat and helps cover transportation operating costs. Missed rides, absences, school closures, or voluntarily discontinued service do not qualify for a refund or credit.
Please acknowledge the following
*
I understand that enrollment will not start until registration has been confirmed through email
I understand that weeks are paid in full regardless of the number of days used
I understand and agree that payments are due weekly, no later than Monday by 12 noon. Payments received after the deadline will be subject to a $35 late fee and services suspended until the account balance is paid in full
All transportation payments are non-refundable/transferrable
By submitting this form you agree to the terms of the Privacy Policy & Refund Policy
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