TRANSPORTATION APPLICATION

I/We authorize KIDDY CARPOOL LLC Transportation to transport my/our child on pre-arranged excursions, which incorporate Door-to-Door services. I/we also authorize my child to ride in a passenger vehicle(s) owned or leased by the KIDDY CARPOOL. I/we understand all such trips are under the supervision of KIDDY CARPOOL chauffeurs and that health and safety precautions are taken in compliance with Georgia Public Transportation standards.
KIDDY CARPOOL TRANSPORTATION

Application & Contract (2022-2023)
Child #1*

First NameLast Name
Male/Female*
Date Of Birth*
MM/DD/Year
Parent/Guardian Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*

Area CodePhone Number
Number*

Area CodePhone Number
Home Number

Area CodePhone Number
Email
example@example.com
2nd Parent/Guardian

First NameLast Name
Cell Number

Area CodePhone Number
Work Number

Area CodePhone Number
Home Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
********MEDICAL CONDITIONS & MEDICATIONS & BLOOD TYPE********

_______________________________________________________________________________

_______________________________________________________________________________
EMERGENCY CONTACT
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Child #2

First NameLast Name
Date Of Birth
MM/DD/Year
Male/Female
Child #3

First NameLast Name
Date Of Birth
MM/DD/Year
Male/Female
If we are transporting your Child/Children to and from School, please complete the section below

School Name*
SCHOOL NUMBER*

Area CodePhone Number
Grade
Teacher's Name
****READ & INITIAL ALL AREAS****
There is a $50 Registration fee due upon return of application.*
Weekly Fees Payments must be paid on Friday no later than Sunday 5pm prior to service being rendered. *
Services will NOT be rendered on Monday without payment made.*
Late Fee is $50.00 a week for each week unpaid, due at time of payment. *
Fees are not PRORATED. Payments are due regardless of CHILD or Children ATTENDANCE. Anything over 2days is considered a full week. *
Fees for ThanksGiving Christmas Break & Spring Break is 1/2 of your weekly payment. Payments is due the week of to maintain your child’s space. (Any and all breaks of over 3 day off) *
CHILD/CHILDREN SHOULD BE READY TO BOARD THE VAN UPON ARRIVAL. A WAIT TIME OVER 2 MINUTES CAN RESULT IN YOUR CHILD MISSING THE VAN. ***WE DO OFFER A COURTESY PHONE CALL UPON REQUEST FROM GUARDIAN 30 MINS BEFORE ARRIVAL.*
IF YOUR CHILD MISSES THE VAN, IT IS NOT KIDDY CARPOOL RESPONSBILITY TO DOUBLE BACK. *********AT THE GUARDIANS REQUEST KIDDY CARPOOL CAN RETURN FOR A FEE OF $25*
Scheduled time of pick up and drop off can change due to enrollments and withdrawals. ****Notice of time change will be given verbally in advance in most cases*****
KIDDY CARPOOL reserve the right to cancel service due to conflicts, lack of area participation, or Child Behavior Problem.*
Parents are responsible for all damages that their children make to the property.*
Any disputes in excess of $2,500 (or the maximum limit for small claims court) arising out of this agreement shall be submitted to binding arbitration before the Joint Ethics Committee or mutually agreed upon Arbitrator pursuant to the rules of the American Arbitration Association. The Arbitrator’s shall be final, and the judgement shall be entered in any court having jurisdiction thereof. The client shall pay arbitration and court cost, reasonable attorney’s fees and legal interest on any awards or judgment in favor of KIDDY CARPOOL LLC.*
The undersigned agrees to the terms of the agreement on behalf of his or her organization or business. No responsibility will be accepted for digital or photocopied signatures.*
I have received a copy of the policy and Procedures and understand my obligations. If at anytime I am unable to fulfill my obligation, I will notify KIDDY CARPOOL Transportation in writing.*
Parent/Guardian Signature*

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KIDDY CARPOOL TRANSPORTATION