Youth Rider Registration Registration forms will be received Monday – Friday Only between the hours of 8-4pm! Step 1 of 5 20% Registrations must be sent by 4 PM!School Year:(Required) 2024-2025 2025-2026 2026-2027 Child's Name:(Required) First Middle Initial Last Address:(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birthdate:(Required) Month Day Year Sex:(Required) Male Female Medicaid # (medical appointments only): PARENT/GUARDIAN INFORMATIONName:(Required) First Last Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone #:(Required)Secondary Phone #: StartStart Date: Month Day Year Start Time:(Required) Hours : Minutes AM PM AM/PM Standing Reservation or Will Call?:(Required) Standing Reservation Will Call Pick up Address:(Required) Street Address Drop off Address:(Required) (School Name) EndEnd Date:(Required) Month Day Year End Time:(Required) Hours : Minutes AM PM AM/PM Standing Reservation or Will Call?:(Required) Standing Reservation Will Call Pick up Address:(Required) (School Name) Drop off Address:(Required) Street Address DaysCheck days needed:(Required) Monday Tuesday Wednesday Thursday Friday Leave unattended?:(Required) Yes No Emergency Contact:(Required) First Last (Different than parent/guardian listed above)Phone #:(Required)Relationship:(Required) Daycare Provider? Yes No If you have a daycare provider select yes to enter their name and phone number.Daycare Provider: Phone #:Others authorized to make changes:(Required) PARENT/GUARDIAN READ AND CHECK THE FOLLOWINGThe below information is true and correct to the best of my knowledge.(Required) I UNDERSTAND People’s Transit is committed to providing NON- discriminatory service and that I may call the office with any concerns. I UNDERSTAND People’s Transit has a NO REFUND POLICY on bus tokens. I UNDERSTAND People’s Transit reserves the right to refuse service. I UNDERSTAND rides must be pre-scheduled the day before by 4:30 PM. I UNDERSTAND my child has three (3) minutes to get to the bus once it arrives. I UNDERSTAND the no show policy (failure to cancel ride/failure to get on the bus) and will be responsible to pay for the no show the next time my child rides. Failure to pay no shows will interrupt service. I UNDERSTAND that after three rides without payment service will be interrupted. Service will resume once payment is received. I UNDERSTAND if the bus must return to pick up my child after missing the bus it will be considered a no show. I UNDERSTAND cancellations must be made by 4:30 pm the day before or at least 30 minutes prior to pick up or a no show policy will be applied. I UNDERSTAND personal information must be updated as needed i.e.…change of address or phone number. I UNDERSTAND ANY misconduct on the bus will result in a warning and a parent/guardian will be notified. If the problem persists the rider may be suspended. I UNDERSTAND BULLYING WILL NOT BE TOLERATED! I UNDERSTAND if parent/guardian/daycare provider is not outside or in the doorway when my child is dropped off, the child will be taken to the office. If no one can be reached by the time our office closes authorities (law enforcement/child protection) will be notified. I UNDERSTAND if my child damages a bus the parent/guardian will be responsible. I UNDERSTAND a new rider registration form must be filled out each school year, as well as summer or after school programs. Select AllParent/Guardian Signature(Required)Additional Authorized Addresses:Name/Address of Destination: Phone:Name/Address of Destination: Phone:Name/Address of Destination: Phone:
