Rider's Registration

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Email *

Name and Date of Birth of Child(ren) *

Name of Parent(s) *

Phone number *

Address *

Emergency Contact - Name and Telephone Number

Special Needs and/or Allergies

Does your child need a booster seat? *

Yes

Medical Authorization - I parent/ guardian of child(ren) on application grant authorization to seek appropriate medical treatment or attention on my behalf of the Minor Children as may be required by the circumstances, including but not limited to, medical doctor and/or hospital visits. I authorize medical treatment or medical procedures in an emergency situation. *

Yes

Required

Initial Pick-Up location *

Initial Drop-Off Location *

Unique School Promo Code

A copy of your responses will be emailed to the address you provided.

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